Q&A: Prof. Patricia Smiley on Mothers, Children and Stress in the Time of COVID-19

Mothers Children Stress Smiley Research

You stress, I stress, we all stress? Psychological Science Professor Patricia Smiley and her team set out to investigate those very questions as they pertain to mothers and their children during the COVID-19 pandemic.

Between 2017 and 2018, Smiley and her collaborators observed mothers with their preschool-aged children during a conversation about an emotionally charged event (for example, a child wanting their dad instead of mom to comfort them). The research team also collected physiological data on stress responses from children, by taking saliva samples during stressful tasks, and from their mothers, by clipping small hair samples.

The mega stress that the pandemic brought with it provided a golden opportunity to use those earlier data to predict who would be more vulnerable to the effects of the pandemic. During the summer of 2020, at the height of the first COVID-19 wave, they remotely interviewed these same mothers, asking them to report which of the following things happened to them since March 2020, and how impactful they were.

Among the 19 questions: Did you get infected with COVID? Did your spouse? Did any of your friends? Did you miss out on important events? Did you lose your job? Was the transition to remote work difficult for you? Did you lose child care?

In this Q&A, Smiley explains the study’s findings. This interview has been condensed and edited for length and clarity.

What did you see happening in mothers in the pandemic study you conducted?

There have been reports from around the world that mothers in particular were impacted by the pandemic because they experienced so many changes in their work and family lives. And in our study, we saw that those who reported more of those stressors from COVID showed an increase in their depressive symptoms from Time 1, our first study, to Time 2, the COVID study.

Depressive symptoms include feeling sad, not sleeping well, changes in appetite, feeling hopeless, feeling like you don't have control over things. Since we had this initial data from the first study, we could actually see not just that the number of stressors was associated with maternal depression, but that there was an increase in depression, compared to a baseline measure, for those who experienced more of these stressors.

What did you see happening in children?

We have mothers’ reports of their children’s behavior from Time 1 and Time 2. Moms reported on externalizing and internalizing problems. We saw an increase in externalizing problems, in other words, kids being defiant, uncooperative, more aggressive, things like that. We found that the moms who reported more stress from COVID perceived their children to be acting out more.

This could reflect a cascading or a shared effect of stressful events. It could be that when moms are more tense or worried, their children become more activated. Or the children themselves could be responding to things like disruptions in their schedule, missing their friends, not seeing their teacher in person, all kinds of things that might have happened to them directly.

What protective measures can mothers implement? And what approaches can they take?

One of the things that we're really interested in is how people manage their emotions. Stressful situations tend to evoke fear, anger, and even sadness, if you're missing out on things. We think of these as “negative” emotions, but they're normal responses to change; these intense emotions go along with being human. If you're a better manager of those feelings in yourself, then we were interested in whether that would have a kind of trickle-down effect on the children.

Emotion researchers think about two kinds of emotion regulation strategies. One is called reappraisal and one is called suppression. With reappraisal you experience a strong emotion, like fear of contracting the disease. Some people are able to say, “Wow, this is a real threat. I need to protect myself, I need to protect my family, how can I do that?” And so they might view it as a more manageable problem that they can strategize and do things about.

In fact, we found that when mothers engaged in more healthy behaviors, masking, distancing, avoiding crowds —we didn't have the vaccine back then. Their own depressive symptoms increased less—it’s like, if I can gain some control, then I don't feel as helpless. I don't feel as sad. My sleep isn't as disturbed, I'm actually doing something to help myself and my family.

On the other hand, there are people who deal with negative emotion by suppressing it. They think those feelings are kind of dangerous or too upsetting, or they just don't want to feel those things. They don't express them; they don't share them with other people. On average, we saw an increase in use of suppression by mothers from Time 1 to Time 2. We also saw that those who used suppression more also reported more depressive symptoms. The more that you’re denying your own emotional response, the worse it is for your mental health.

For the moms who used reappraisal rather than suppression, the moms who tried to put a more realistic face on the pandemic, accepted it, tried to do something in response to it, those moms had children with smaller or no increases in internalizing problems. Children with internalizing problems worry a lot, cry, get anxious, are clingy. In other words, moms who were better able to manage their own emotions had kids who were doing better.

Another thing that you can do in terms of a protective factor is teach your children about emotions. So not just manage your own but teach your kids about how emotions work. You can name emotions: “Mommy is feeling sad,” or ask, “Do you miss your teacher?” If your child shows an emotion, you can explain it, connect it to the likely cause, “Oh, I see you’re really sad this morning. Are you missing school?” Or, “We had to cancel the birthday party. I'm so sorry. You were really looking forward to it. Let’s see what else we can do instead.” We call this kind of conversation emotion-coaching.

Coaching children through emotional episodes can provide real benefits. One of the things that we did in the COVID interview during summer 2020 was to ask the mother to talk to her child about the pandemic, about the changes that had occurred and how they felt about it, and what they did in response. It was just a very general instruction. We coded those conversations for evidence of emotion-coaching.

It turned out that moms who did more emotion coaching of the kind I just described had children with the smallest or no increases in externalizing problems. The big takeaway from these findings is that moms who manage their own emotions well and moms who teach or coach their children about emotions, don't ignore those feelings, have children who do better.

There are some people who might need to take extra care during highly stressful times like these. For example, we found that those moms who had shown greater concentrations of the stress hormone cortisol in their hair in the first study were more likely to show an increase in depressive symptoms from pre-pandemic to during the pandemic.

In this pandemic, if you’re already a person who’s reactive to stressful things, you’re more vulnerable. If you have some awareness that you are a person who’s reactive, then self-care just becomes really important.

One route to self-care is to slow down, not do as much as you did before, not pressure yourself to do things as usual. Taking a little time for some self-care at home, or going outside for a walk, can be helpful. And, if you know you are the kind of person who responds strongly to change or to new stressors, then try to pay even more attention to caring for yourself or focusing on the enjoyment you can get from spending time with your children, friends and partners.

Can you speak to how this affects development in children?

Well, we don’t know the full extent of effects on children. Anecdotally, young children who are in the language-learning stage, so two years old, have displayed speech problems. They’re less able to accurately pronounce their words. Because language learning involves watching lips and matching lip movements to what you hear. That’s how babies learn to babble and form their initial sounds.

If you’re two years old and you’re not seeing lip movements of the people who are speaking to you, because they are all wearing masks, you’re making your best guess about how to make the sound that you’re hearing. So children will have some, hopefully temporary, impairments.

Another thing that we’re looking at right now in our lab is whether the amount of social experience that children maintained during the pandemic period is related to their mental health now. In a third wave of our study (late summer to fall 2021), we’ve done another remote interview with moms and children, asking the mothers, “How did schooling go during the pandemic year? Did you have a learning pod? Was your child learning online? Were you homeschooling by yourself? Did your child have in-person play times?” We know that in this developmental stage, between ages four and seven, peer association is really, really important. It’s how you learn your social skills like listening, cooperating, joining a group; you learn to express and manage your emotions. You learn about other people’s points of view. Even academic learning benefits from working with peers.

If you’re not having social experiences, children might not acquire essential social skills or develop feelings of anxiety. In addition to asking moms how they constructed their child’s social world during the pandemic years, we also asked children to respond, themselves — because now they are seven or eight years old — to a questionnaire about anxiety and depressive symptoms. We’re hearing from the children themselves about how much they feel sad, or jittery, or nervous, bad about themselves, or afraid to go back to school, those sorts of things. As we look at these data, we will be able to understand the effects of pandemic stress and the effects of disrupted social experience on children’s well-being.

Finally, we know, in general, that there’s learning loss, but it will take some time to see the full extent of the impact of the pandemic on learning.

What else can parents do for themselves and their children?

I think parents already do this when their children are stressed or experiencing loss or disruption — use comfort objects to soothe and physical activity to promote positive emotion — but children might need these things even more these days. They might need more cuddle time or more outside time with you, or they might need more one-on-one attention.

Even though mothers and fathers, through this pandemic, might feel like they don’t have any more to give, some parents find the extra time with their children and with each other rewarding.

The families we worked with in this longitudinal study (sponsored in part by the National Science Foundation) represent a fairly diverse sample from the surrounding area — about 40% Latinx, 40% White and 20% other races/ethnicities, with a wide range of incomes. We can therefore feel fairly confident that our findings apply to families like these. We have not worked with very low-income or socially at-risk families, who have had much greater struggles due to job loss or illness and death, or complete school disruption due to the pandemic. Developmental scientists will want to keep in mind the wide range of experiences among families in the U.S. as we begin to recover from the mental health impacts of the pandemic.