Psychological Insights for Understanding COVID-19 and Families, Parents, and Children

Marc H. Bornstein

• Publisher: Routledge
• Year: 2020
• eBook ISBN: 9781000338218
• Topic: Psychology
• Subtopic: Diseases & Allergies
• Index: Psychology

With specially commissioned introductions from international experts, the Psychological Insights for Understanding COVID-19 series draws together previously published chapters on key themes in psychological science that engage with people's unprecedented experience of the pandemic.

This volume collects chapters that address prominent issues and challenges presented by the SARS-CoV-2 pandemic to families, parents, and children. A new introduction from Marc H. Bornstein reviews how disasters are known to impact families, parents, and children and explores traditional and novel responsibilities of parents and their effects on child growth and development. It examines parenting at this time, detailing consequences for home life and economies that the pandemic has triggered; considers child discipline and abuse during the pandemic; and makes recommendations that will support families in terms of multilevel interventions at family, community, and national and international levels. The selected chapters elucidate key themes including children's worry, stress and parenting, positive parenting programs, barriers which constrain population-level impact of prevention programs, and the importance of culturally adapting evidence-based family intervention programs.

Featuring theory and research on key topics germane to the global pandemic, the Psychological Insights for Understanding COVID-19 series offers thought-provoking reading for professionals, students, academics, policy makers, and parents concerned with the psychological consequences of COVID-19 for individuals, families, and society.

CHAPTER ONE
Children’s worry and development

Charlotte Wilson

WORRY IN A DEVELOPMENTAL CONTEXT

The previous chapter explored the concept of worry and the definitions that have been used for adults and children. One of the criticisms that has been raised about our current understanding of children’s worry is that it adapted from our understanding of adult worry. As Vasey and Daleiden noted back in 1994:

While caution is necessary when applying adult-based models to children, their careful use can provide an important heuristic for initial research efforts. As research progresses, we expected that a more developmentally appropriate model of worry in children will emerge.

Vasey and Daleiden (1994, p. 186)

Unfortunately, this model has not emerged. Applying adult models to children risks missing some of the key differences that may be present due to development. If we explore the different facets of worry we find that a number of these change across childhood and are predicated on cognitive, language, social, and emotional development. This chapter reviews these different facets of worry and details the literature to date that helps us understand the early development of worry.

DEVELOPMENT OF WORRY ACROSS CHILDHOOD

Throughout childhood there are changes and transitions that mark children’s lives. These range from physical transitions such as growth spurts and puberty, to social transitions such as starting school, starting secondary school, dating, and making and breaking friendships. In addition to predictable transitions are those that are common across childhood that are more individual and unpredictable such as moving house or moving school, childhood illnesses, and the arrival of siblings. All these events can prompt children’s worries, but other aspects of children’s development also appear to impact what children worry about.

The interest in how worry changes across childhood dates back to the earliest studies of worry in children. Writing in 1953 Angelino and Shedd report:

Very broadly and only with reservation can we state that at age 10, 11, and 12 we find a preponderance of fears connected with animals. At 13 we find a shift to school-connected content. At age 15 this content appears to give way to economic and political interest which increases through age 18.

Angelino and Shedd (1953)

Over 60 years later their findings are still relevant and represent a good description of what changes in children’s worry over time. A number of studies have explored changes in children’s worry, and these have used a wide variety of methodologies to determine such changes (see Chapter 1 for a review of these). Some studies have used lists of worries generated from pilot work and asked children to rate them on frequency and intensity (e.g. Brown et al., 2006). Others have used semi-structured interviews which combine open-ended questions with structured prompting about specific worries (e.g. Henker, Whalen, & O’Neil, 1995; Laing et al., 2009; Muris et al., 2000; Silverman, Greca, & Wasserstein, 1995). Only a small number of studies have used formal questionnaires of worry or worry processes to look at developmental changes (e.g. Barahmand, 2008; Chorpita et al., 1997; Pasarelu et al., 2017). From these studies it appears that there is some evidence that worry frequency increases to age ten (Caes et al., 2016; Muris, Merckelbach et al., 2000; Muris, Merckelbach, Meesters, et al., 2002) and then declines after that (Caes et al., 2016; Laing et al., 2009), but that the intensity of worries declines more in mid-childhood and increases after that (Caes et al., 2016; Silverman, Greca, & Wasserstein, 1995). However, the evidence isn’t strong and with such varied methodologies, respondents, and age ranges it is hard to strongly support the idea of developmental changes in the frequency and intensity of worries (Cartwright-Hatton, 2006).

What is much clearer is that, as suggested by Angelino and Shedd, the content of children’s worries changes over time. In young children the predominant worries, just like predominant fears, are physical and immediate. These include worries about animals, separation from parents, and bullying (Laing et al., 2009; Muris, Merckelbach, et al., 2000; Stevenson-Hinde & Shouldice, 1995). At older ages children become more worried about school, health, physical appearance, and personal harm (Brown et al., 2006; Caes et al., 2016; Henker, Whalen, & O’Neil, 1995; Muris, Merckelbach, et al., 2000), with only the oldest children worrying about social ills (Angelino & Shedd, 1953; Henker, Whalen, & O’Neil, 1995).

Alongside this development in the content of worry is development in children’s ability to describe their worries with greater elaboration (Henker, Whalen, & O’Neil, 1995). Indeed, given the development of language and introspective capacity across childhood it is difficult to determine whether it is the experience of worry that changes or the ability to talk about it. Furthermore, given that worry is defined as primarily verbal it is difficult to determine whether it is increased language and cognitive ability that opens up the ability to think and therefore worry about different topics or whether the developmental shifts in the content of worry reflect children’s widening experience of the world (Muris, Merckelbach, Meesters, et al., 2002). Given that many of our interventions for anxious and worried children are predominantly verbal exploring the inter-relationships between language development and worry development may be important. Examining whether there are developmental shifts in the components of worry and processes involved in worry may also help us understand whether the adult models of worry do really help us understand worry in children.

Another aspect of children’s experience that is likely to impact the content of their worries is their cultural context. Several studies have concluded that anxiety symptoms in children do differ across different cultures (Essau et al., 2004; Silverman, Greca, & Wasserstein, 1995; Varela et al., 2008), with differences found in which anxiety disorders are most prevalent, which fear is most commonly reported, and which wider anxiety symptoms are reported. These of course represent different aspects of the experience of anxiety; the reporting, and even experiencing, of different symptoms is likely to be influenced by the social desirability of such symptoms in your society, with somatic symptoms being more socially accepted than emotional symptoms in some families and in some societies (e.g. Varela & Hensley-Maloney, 2009). The prevalence of individual worries also likely represents individual children’s experiences. If you live in poverty with uncertain access to food and shelter, then your worries are more likely to be about hunger and safety. Whereas if you are wealthy and not living in precarious circumstances, your worries are more likely to be about friendships, school, and achievement. What appears to be the case, however, is that there are more differences between individuals in different cultures than there are between cultures. Furthermore, the content of worry does not appear to determine strongly whether it is becomes a problem. Chapter 4 will further review cross-cultural differences in the mechanisms involved in problematic worry.

COMPONENTS OF WORRY

As we saw in the previous chapter there are a number of different psychological processes involved in worry. Worry anticipates the future. This needs a child to be able to anticipate and think about the future and to think about hypothetical situations. Worry is iterative. This needs a child to be able to think repeatedly about one situation. This might involve sustained attention and might involve thinking about complex ideas where iteration of thought is possible. Worry involves or feels like problem solving and more often than not this will be social problem solving. This ability to solve social problems emerges throughout childhood and involves social and emotional skills, as well as cognitive and language skills. Problematic worry involves catastrophisation. This requires complex cognitive and language skills.

When worry is broken down into the different components, it is clear that all aspects of development are implicated, from cognitive and language development to emotional and social development. This chapter focuses on these four components, exploring what we know about how they develop across childhood and adolescence and then linking this to our understanding of the development of worry.

FUTURE THINKING

Future thinking has been described as one of the most important processes within human cognition, with some researchers suggesting that it distinguishes us from other species (Atance & O’Neill, 2005b). It is future thinking that allows us to prepare for and plan our own futures, whether explicitly or implicitly. Therefore, worry may be seen as future thinking that aims to prepare for and plan for the negative or catastrophic possible futures. Future thinking is a fundamental part of worry. Although you can worry about things past, it is usually the impact they may have on the future that is concerning. The focus on the future in worry may be one of the factors that distinguishes worry from rumination (Segerstrom et al., 2000), and therefore this future focus in worry needs consideration of the complex cognitive processes involved in putting ourselves into possible futures.

Much work has been done on children’s ability to think about the future or mentally time travel. For example, Suddendorf (2010) asked three- and four-year-old children to say something that they would be doing tomorrow. Their parents were asked to rate whether these events were likely, and it was found that at four years of age, children almost always proposed realistic events, but younger than this, the ability was more unreliable. Across this age range (three to four years) a significant minority of children could not talk about something they would be doing tomorrow. In a slightly different paradigm, Atance and O’Neill (2005a) gave children a number options of what to take with them on a future trip. They chose from a pool of desirable and helpful options and then justified their choices. The determination of whether the child was thinking about the future or not was on the basis of how they justified their choice. They found that at age three, about 40–50% children were justifying their choices using future focused language. Extending this Atance and Meltzoff (2005) asked three, four, and five year olds about a possible future event, but this time the event called for a specific item; for example, one prompt involved a snowy scene, and the options children could choose were a winter coat, arm bands (water wings), or a towel. All children chose the correct item at a level better than chance, but this approached a ceiling level with the four and five year olds (91% and 97% correct, respectively). Differences between the different ages were even more marked for using future language in justifying the choices, with 35%, 62%, and 71% of three, four, and five year olds using future state language in their justification. We replicated these findings using a different scene involving a tropical greenhouse full of insects (Barrett & Wilson, 2019). Once again we found that children chose appropriate items more often than they used future uncertain terms to justify them. This ability to justify choices using these future uncertain terms was related to age but not to verbal ability (Figure 2.1).

Figure 2.1 Items used in the future thinking task.

The reliance on language for determining future thinking has some limitations, especially as these future thinking skills are developing at the same time that language is at a basic level but is quickly advancing. Therefore other experimental paradigms haven’t relied on language. For example, Suddendorf, Nielsen, and von Gehlen (2011) showed children a puzzle that they couldn’t complete because they didn’t have all the parts. They then showed the children into a different room for a different task. However, in this second room was the part that the child needed to complete the puzzle in the first room, along with other desirable objects. As they left this second room children were asked to choose an object that they would like to take back into the first room. The reasoning was that children who were thinking about the future would choose the object that was needed to complete the puzzle, but those who weren’t would just choose a more desirable object. At three years of age children chose the correct object at a chance level, but by four years of age children more often chose an object that could help them solve the problem.

A different but related body of research focused on children’s thinking about the future is counterfactual thinking. Worries can typically be viewed as hypothetical thinking about the future, whereas counterfactual thinking is when future possibilities are in contradiction to what is currently happening or known. So, if worry is asking ‘what if?’ counterfactual thinking is asking ‘what if that hadn’t happened?’.

Alice got her exam results and was disappointed. She was worried about whether it might impact on her future choices and her future career. Very soon she was thinking to herself, ‘if only I had studied harder’, ‘if only the right question had come up on that test paper’ ‘if only I had eaten a proper breakfast the morning of the exam’.

There is debate about what age children start being able to think counterfactually (Beck et al., 2014) that mirrors the debate about hypothetical future thinking. There is some evidence that a certain kind of counterfactual thinking is present from about three years of age (Harris, German, & Mills, 1996; Robinson & Beck, 2000), whereas other researchers suggest that it starts a little later, from four years old (Riggs et al., 1998). It does appear, like hypothetical future thinking, to develop through childhood into adolescence, with greater complexity and capacity for abstraction (Beck et al., 2014; Rafetseder & Perner, 2012).

Therefore it suggests that the ability to think into the future does start early, from age four to five or so but that the nature of the task might significantly impact this. Therefore another interesting question is not when children develop this ability to me...

Table of contents

• Cover
• Half Title
• Series Page
• Title Page
• Copyright Page
• Selected chapters
• Contents
• List of contributors
• Introduction: The SARS-CoV-2 pandemic: issues for families, parents, and children
• 1 Children’s worry and development
• 2 Stress and parenting
• 3 Youth–adult relationships as assets for youth: promoting positive development in stressful times
• 4 Employment and parenting
• 5 The triple P – positive parenting program: a community-wide approach to parenting and family support
• 6 Thinking systematically for enduring family change
• 7 Cultural and gender adaptations of evidence-based family interventions