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The Little Professor and the Virus: Scaffolding Children’s Meaning Making During the COVID-19 Emergency

Authors:
The Little Professor and the Virus:
Scaffolding Childrens Meaning
Making During the COVID-19
Emergency
Livio Provenzi
1
*, Elisa Barofo
2
, Susanna Ligabue
3
and Renato Borgatti
1,4
1
Child Neurology and Psychiatry Unit, IRCCS Mondino Foundation, Pavia, Italy,
2
AGRES Onlus, Massina di Cislago, Italy,
3
Centro di Psicologia e Analisi Transazionale, Milano, Italy,
4
Department of Brain and Behavioral Sciences, Università di
Pavia, Pavia, Italy
Keywords: COVID-19, child, parent, emotion regulation, meaning making, pandemic, emergency
From the very rst years of life, children try to make sense and meaning out of the different stimuli
they receive from their physical and social caregiving environment. Eric Berne used to refer to this
precocious intuition of the surrounding world as a Martian thinking, the naivest possible frame of
mind for observing Earthly happenings(1). This way of thinking is typical of the psychological
Child Ego state called the Little Professor, which harbors strategies that the child possesses for
solving problems: intuition and prelogical thinking (2). So, with the little professorwe can refer to
the intuitive and creativerather than logicalthought process that builds on the explorative
attitude of young children and on their sensitivity to the surrounding environment (3). Of course,
this meaning-making process is far from being a conclusive viewpoint on reality and it is critically
affected by direct and indirect messages received from the adult caregivers, especially the parents.
As the coronavirus disease of the 2019 (Covid-19) is rapidly spreading worldwide, its reasonable
to assume that even the childrensLittle Professoris trying to develop a naïve theory of what is
happening in the external world by incorporating different information sources. These may include
the verbal messages (e.g., information, explanations) and the emotional expressions of their parents
as well as delivered by the media and other adults. Notably, even when language comprehension is
not fully developed, children are highly sensitive to the prosodic elements of human
communications, including adultsgesture and voice tone (4). For this reason, the parental
scaffolding of meaning-making processes is crucial to help children cope with such unexpected
and frightening events, disentangling unclear messages and making order within the large amount
of potentially confusing information they receive about the Covid-19 epidemic (5). Indeed, children
are now surrounded by adults wearing masks, talking to each other about the infection and they can
perceive alarm and distress by looking and listening to them. They are supposed to change their
habits: to respect strict hygiene standards and to remain at home with a dramatic reduction of
physical social exchanges with peers. Additionally, they may have faced for the rst time the loss of a
signicant person in their family. At the present moment, it is not easy for most parents to nd
veried and reliable information on the nature of this coronavirus as well as on the healthcare risks
for themselves and their children (6). Scientists themselves are trying to understand the nature of
the virus and they do not have conclusive estimations on the health-related risk as well as on the
time course of the emergency (7).
Frontiers in Psychiatry | www.frontiersin.org August 2020 | Volume 11 | Article 8171
Edited by:
Gianluca Castelnuovo,
Catholic University of the Sacred
Heart, Italy
Reviewed by:
Mia McLean,
University of British Columbia, Canada
Eugenia Conti,
University of Pisa, Italy
*Correspondence:
Livio Provenzi
livio.provenzi@mondino.it
Specialty section:
This article was submitted to
Public Mental Health,
a section of the journal
Frontiers in Psychiatry
Received: 09 April 2020
Accepted: 29 July 2020
Published: 13 August 2020
Citation:
Provenzi L, BarofoE,Ligabue S and
Borgatti R (2020) The Little Professor
and the Virus: Scaffolding
Childrens Meaning Making
During the COVID-19 Emergency.
Front. Psychiatry 11:817.
doi: 10.3389/fpsyt.2020.00817
OPINION
published: 13 August 2020
doi: 10.3389/fpsyt.2020.00817
This uncertaintytogether with the lack of a specicand
effective treatment for the Covid-19can further feed the fears
and the sense of vulnerability of citizensboth adults and children.
In this context, whereas the healthcare policies adopted by different
countries could help to contain and mitigate the infection spread,
for most families they also represent severe restrictions to social
relationships and habits (8). Previous research on the well-being of
parents and children during and after healthcare emergencies
suggest that both can develop post-traumatic stress symptoms
(9). Increased prevalence of post-traumatic stress symptoms was
reported in survivals of the SARS epidemic (10)andpreliminary
evidence of similar psychological effects are also emerging for the
Covid-19 emergency (11). Notably, the stress perceived by parents
may widely affect parenting behaviors (12) and the quality of
parent-child interaction (13,14). Neuroscientic(15)and
epigenetic (16) evidence suggests that these stress-related
parenting effects may have profound intergenerational
consequences for childrens emotional and cognitive development
(1719). Thus, it is not surprising that the psychological
consequences of Covid-19 emergency have been identied as the
second tsunamiof this unprecedented pandemic (20).
In sum, scaffolding childrens meaning-making process
during the present pandemic is crucial to help them cope with
the emergency situation and to avoid the overwhelming and
traumatic effects of misleading or partial cognitive appraisal and
emotional over-reactions. It is possible to identify different ways
in order to create a safe environment in which parents and other
adult caregivers (e.g., teachers, educators) can help young
children to deal with the COVID-19 emergency. In this article,
we would like to highlight four ways through which adults can
guide their children through the meaning-making process: self-
regulation, careful listening, simple talking, and playing and
practicing together (Figure 1).
First, parents should be in touch with their emotions and they are
warranted to recognize, express, and regulate them in an adaptive
way. Despite school-aged children may have a greater understanding
of the verbal content of adultscommunications, infants are already
sensitive to non-verbal cues such as looking, pointing, vocal tone,
and other adultsemotional and social expressions (21,22). Even
during preschool age, children could perceive the adultsemotional
state and they could respond consistently (23). Nonetheless, as
especially young infants during the rst two years of life may have
only a partial access to the meaning of adultscommunications,
their Little professor”—who is constantly in search of coherent
meaningsmay be especially vulnerable to misinterpretations and
pragmatic errors (24). In this context, infants may use the emotional
expression of the caregivers to interpret the safety of ambiguous
conditions (i.e., meaning-making) and to adopt consequent problem
solving actions (e.g., coping strategies). The social referencing
literature has largely provided examples of this by means of the
so-called visual cliff experiment. Inthevisualcliff,infantsmoveona
glasscovered table divided into a shallow side under which a
checkered pattern is placed right beneath the glass and a deep side
under which a similar pattern is placed some distance below the
glass, creating an apparent drop (25,26). When mothers posed a
happy expression, almost all infants crossed the cliff,whereas none of
the infants who observed mothersfearful expression crossed,
suggesting that at least from 12-month age infants resolve
ambiguous conditions by integrating the parentsemotional
expressions in their implicit meaning-making (27). For this
reason, caregivers should validate their own feelings of anxiety,
fear, and worries and they should not neglect them dismissively.
Afterall,itisinthereciprocalandmutual exchange of affective states
that happen within the parent-child relationship, that children can
develop appropriate and successful emotional regulation strategies
and resilience to stress (28).Parentswhoareabletobeindeeptouch
with their affective inner world, validating not only their positive
emotional states but even depressive and anxious ones, can provide
regulatory support and help their children deal with similar feelings,
co-constructing with them instruments capable of adaptive
emotional regulation (5). In other words, parents who let
themselves express their real emotions will also grant the same
permission to their young children. Reassuring children about the
perceived alarm and risk for health can be successful only if it
FIGURE 1 | Schematic overview of parental actions aimed at supporting childrens meaning-making during the Covid-19 emergency.
Provenzi et al. The Little Professor and the Virus
Frontiers in Psychiatry | www.frontiersin.org August 2020 | Volume 11 | Article 8172
happens within a relationship characterized by genuine and open
sharing of affective states.
Second, adults that do not neglect their own emotions can also
promote a careful listening of childrensaffectivemessagesand
communications. By supporting their childsspontaneous
emotional expression, adults can detect how the Little Professor
in their child is trying to develop a coherent meaning of the
situation. Indeed, previous research suggests that family-based
narrative approaches provide a structured opportunity to elicit
parentsand childrens meaning-making, assemble divergent
storylines into a shared family narrative, and thereby enhance
membersskills to cope with stressful and traumatic events
developing hope and trust in family support (29). Careful and
open listening by parents can allow children to freely express their
feelings of fear and worries about the emergency within a
relationship in which they may feel safe and protected (30). It
should be highlighted that this personal creative and intuitive way of
meaning making which is typical of the little professoris often
limited in options (31). It provides emotional containment and
protective survival strategies that require further scaffolding and
permissions from parents to allow the emergence of more
functional and adaptive coping strategies to face challenging life
conditions. Additionally, far from hinder this intuitive thinking,
adults can engage in a careful listening of children emotional world
and they can understand which are the elements contributing to the
emergent meaning-making process that they are developing (32).
This is a crucial step for parents to provide further explanations to
children and to promote a positive dialogue about the affective states
and the cognitive representations arising from the lived experience
of the Covid-19 emergency. Moreover, it should be important to
note that this particular attitude to careful listening is warranted to
continue across time as new information and knowledge can arrive
to the children in different moments, thus requiring continuous
interactive rearrangement and mutual renement of the meaning-
making process.
Third, when adultsself-regulation is in place and careful
listening is available for children, caregivers can now provide
active contributions to the meaning-making process by using
simple language. Avoiding complex concepts and explaining the
emergency-related issues with age-appropriate words is crucial to
clean up the messy ensemble of information to which the children
are exposed (33). For example, receiving communications expressed
in simple language can help the children to understand the Covid-
19 symptoms, the risk factors and the appropriate behaviors needed
to deal with the emergency. As the Little Professoruse intuitive
and analogic forms of representations, the use of metaphors,
drawings and as iflanguage can facilitate the integration of
information by the child, stimulate curiosity and avoid the
emergence of monstersor the persistence of scaring images in
the meaning mindset of the child. Moreover, mother and fathers are
encouraged to talk with their child together, as a way to
communicate that the family as a system is coherent and to
reinforce the strength of the messages. From this perspective,
observing childrens spontaneous and subjective creations may
allow the adults to monitor the meaning-making process that is
unwinding within their inner world.
Fourth, the active engagement of parents during recreative
activities can further scaffold childrens meaning-making during
the Covid-19 emergency. Indeed, recreational activities represent
the best secure setting in which parents and their children can
share meanings about the actual emergency (34). During
these moments, caregivers can enhance childrensintuitiveand
creative thinking, offering them coherent explanations about
what is happening and directly co-constructing meanings
and representations. As previously mentioned, the precocious
experiences of parental holding and emotional regulation are key
to make meanings about the physical, social, and psychological
world the child is living in. For example, drawing and playing
together allow parents and children to co-create a shared symbolic
and analogic language through which a sensitive emotional
education process is warranted to enhance childrens capacity to
perceive, label, and differentiate among their own emotional
feelings and affective states (35). By playing and practicing
together, parents and children develop a shared grammar of
meanings that will contribute to create a safe environment for
psychological, emotional, and cognitive explorations later in life
(36). In this crucial process, caregivers act like a mirror that may
reect and disentangle their childs affective states. The current
Italian context provides a clear example of this co-creation, which
is the shared drawing of rainbows with the claim Everything will
be all right. This symbolic creation highlights the importance to
develop a common symbolism within the family that can also be
shared on-line with peers, contributing to support hope and
resilience for the future (37,38).
In sum, in times of such an unprecedented global healthcare
emergency, adults have the responsibility to take care and
partner with children in producing integrated, coherent, and
adequate meaning-making on the pandemic (39). In fact, young
children create internal representations of their experiences of
being-withthe adult caregivers who support them to make
sense about the surrounding environment (40). The cognitive
and emotional appraisal of subjective experiences by the Little
Professorallow the development of adaptive reactions to the
situation and peculiar and subjective survival strategies. For this
reason, by helping the present generation of children in dealing
with the Covid-19 emergency, we hope adults can successfully
contribute in nurturing a new generation of human beings that
will share enhanced resiliency when faced with future
unexpected and stressful events.
AUTHOR CONTRIBUTIONS
LP and EB conceived this work. EB, SL, and RB contributed to
the drafting of the nal version of the manuscript. All authors
contributed to the article and approved the submitted version.
FUNDING
This work was supported by funds from the Italian Ministry of
Health (Ricerca Corrente, year 2020; 5 X 1000, year 2017) to
LP and RB.
Provenzi et al. The Little Professor and the Virus
Frontiers in Psychiatry | www.frontiersin.org August 2020 | Volume 11 | Article 8173
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Conict of Interest: The authors declare that the research was conducted in the
absence of any commercial or nancial relationships that could be construed as a
potential conict of interest.
Copyright © 2020 Provenzi, Barofo, Ligabue and Borgatti. This is an open-access
article distributed under the terms of the Creative Commons Attribution License (CC BY).
The use, distribution or reproduction in other forums is permitted, provided the original
author(s) and the copyright owner(s) are credited and that the original publication in this
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Provenzi et al. The Little Professor and the Virus
Frontiers in Psychiatry | www.frontiersin.org August 2020 | Volume 11 | Article 8174
... As with any other conceptual domain, children form their understanding of COVID-19 by combining a large amount of information from different sources, including media (multimodal) messages, explanations, and emotional reactions of family members, or other social contacts (Provenzi et al., 2020). Thus, scaffolding children's meaning-making of COVID-19 is essential to support them in handling this unpredictable situation and in avoiding traumatic effects (Assante and Candel, 2020;Idoiaga et al., 2020). ...
... Drawing-based studies have confirmed that children identify illness primarily as a biomedical situation (Myant and Williams, 2005;Schmidt and Frohling, 2006), but have also revealed an appreciation of its consequences on one's social and emotional adjustment (Bonoti et al., 2019;Zaloudikova, 2010). This is no surprise, since public reactions to illness and viruses are highly emotional, due to the danger and uncertainty they entail (Joubert and Wasserman, 2020;Provenzi et al., 2020). As a consequence of the COVID-19 pandemic and its resulting restrictions, children have been found to report negative emotions -mainly fear (Assante and Candel, 2020;Garcia de Avila et al., 2020;Li et al., 2020), but also sadness, anxiety, anger, boredom, fatigue, loneliness and concern (Idoiaga et al., 2020;Soma, 2020). ...
... The outcomes of the present study have several implications on raising children's awareness of COVID-19 and supporting them in addressing similar risks they may face in the future. Scaffolding children in coping with such crises involves providing simple and clear information and explanations to support understanding, along with emotional expression and awareness (Provenzi et al., 2020;Soma, 2020). ...
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Despite the growing body of research on the consequences of the COVID-19 pandemic on children’s wellbeing, few studies so far have explored children’s points of view, while the majority were based on data collected during the first year of the pandemic. The present study attempted to capture children’s views 1 year after the beginning of the pandemic, and to this end, data were collected during Spring 2021 in Greece. Specifically, by combining verbal and visual data, the study attempted to explore children’s views of SARS-CoV-2 and COVID-19 preventive practices. Participants involved 320 children, ranging in age from 4 to 12 years, who were asked to verbally describe and draw (a) Coronavirus and (b) the preventive measures adopted to mitigate the pandemic. Data analysis indicated that overall, children’s views involve elements of scientifically appropriate information since from an early age they are able to describe and depict SARS-CoV-2 in ways that reflect the abundance of available verbal and visual information in the public sphere. Moreover, children recommended suitable COVID-19 preventive practices since their verbal and drawing responses included references to both the Hygienic and Social preventive practices that prevailed during the time of data collection. Age-related differences in children’s views, as well as differences between the two data collection techniques, were also found. Results also showed that children who described SARS-CoV-2 as a virus or a germ tended to report more hygienic practices than those who failed to describe the term appropriately. The findings shed light on the way children form their views of the novel coronavirus and COVID-19 and raise research educational implications.
... Considering the influential role of the visual mode on children's learning, if images in ebooks about COVID-19 align with the socio-cognitive pedagogical principles in terms of address and involvement, then these books may have the potential to promote effective learning experiences and promote desirable behaviours. Furthermore, the kind of young children's learning experiences about this topic may have implications for their future life, especially concerning their ability to transfer this knowledge to analogous challenging situations yet to come (Provenzi et al., 2020). ...
... Therefore, it is important that mediating tools with ample visibility, like images in publicly available e-books, enhance children's learning and positive action and strengthen their participation in slowing down the spread through instigating preventive measures and hygiene practices. Furthermore, meaningful learning experiences -like those promoted by the visual interpersonal messages in the analysed e-books-may support children in transferring their existing knowledge to similar emergencies in the future (Hirsh-Pasek et al., 2015;Provenzi et al., 2020) and become active and socially responsible citizens (Erduran, 2020). The results of the present study indicate that the analysed images in e-books about COVID-19 may contribute to this direction since they tend to promote pedagogically appropriate messages and have the potential to support young children's effective and meaningful learning experiences. ...
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COVID-19 e-books have emerged as means for communicating information about coronavirus and the resulting disease to children during the pandemic. This material is multimodal, with images forming the most prevalent and crucial semiotic mode. Except for representational and compositional meaning, an image realises interpersonal meanings. The degree to which the reader is activated (address) and prompted to become engaged with what is represented (involvement) constitute interpersonal meaning dimensions that reflect crucial pedagogical perceptions about children’s learning. This study explored how address and involvement are visually realized in young children’s e-books about COVID-19. The sample consisted of 100 randomly selected images of living or anthropomorphic entities included in 18 COVID-19 e-books for young children. The framework of analysis was based on the Grammar of Visual Design. Results indicate that the analysed images mostly assign children both roles of information receivers and active learners, while encouraging their engagement with what is represented. These interpersonal meanings largely align with the socio-cognitive perspective on young children’s learning. The study could support teachers in the selection, design, and use of multimodal learning materials to promote children’s visual literacy, especially in emergency conditions as those imposed by the COVID-19 pandemic.
... Some of the issues connected to these crisis situations are of relevance for civic education, such as the impact of the pandemic on schools, students and learning environments as well as its effect on political institutions and democratic values. While school closures and the growth of digital learning formats have led to negative impacts on students' motivation and overall achievement, disproportionally affecting disadvantaged students and emphasizing the need for supportive pedagogy (Catalano et al., 2021;Kuhfeld et al., 2020, Yates et al., 2021, the pandemic has also highlighted the influence of meaning making on coping with difficult situations (Provenzi et al., 2020;Yang et al., 2021). For civic education, processes of meaning making become especially relevant when they are connected to beliefs in conspiracy theories and antidemocratic sentiments, which have been gaining popularity during the COVID-19 pandemic (Davies et al., 2021;Romer, Jamieson, 2020;Rothmund et al., 2020). ...
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Crisis situations are connected to different processes of meaning making, both public and private. While different organizations and public actors engage in public discourses regarding the correct interpretation of the events unfolding and the adequate responses to them, individuals are looking for explanations to imbue the events they are experiencing with meaning. For civic education, both aspects are of relevance, especially when an increased need for meaningful narratives leads to a growing belief in and spread of conspiracy theories. During times of crisis, learning should be seen as meaning making, a culturally shaped process in which objects or events gain significance for students. The uncertainty, need for understanding and public discourse prevalent during times of crisis lead to a relevance of meaning-oriented approaches to civic education, which are not only aimed at imparting knowledge, but also include the engagement with and reflection of processes of meaning making.
... Some of the issues connected to these crisis situations are of relevance for civic education, such as the impact of the pandemic on schools, students and learning environments as well as its effect on political institutions and democratic values. While school closures and the growth of digital learning formats have led to negative impacts on students' motivation and overall achievement, disproportionally affecting disadvantaged students and emphasizing the need for supportive pedagogy (Catalano et al., 2021;Kuhfeld et al., 2020, Yates et al., 2021, the pandemic has also highlighted the influence of meaning making on coping with difficult situations (Provenzi et al., 2020;Yang et al., 2021). For civic education, processes of meaning making become especially relevant when they are connected to beliefs in conspiracy theories and antidemocratic sentiments, which have been gaining popularity during the COVID-19 pandemic (Davies et al., 2021;Romer, Jamieson, 2020;Rothmund et al., 2020). ...
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The operational guidelines of the National Strategies and the 2030 European Agenda for Sustainable Development towards educational activities underline the importance of fostering creative, inclusive, and positive communities in resilient territories; for an educational action-oriented towards social sustainability development and well-being. In these novel scenarios, care management and educational responsibilities become strategic assets for the future of civil society, capable of supporting the challenges in contrast to the current educational poverty. The ‘generative’ action requires a holistic transdisciplinary intervention conceived in the Deweyan perspective of learning by doing. In this sense, we present the Association of Responsible Adults for a United Territory against Risk (ARTUR) and its Laboratories for Adolescents and their Needs (ARTUR LAB). The ARTUR aims to implement pedagogic interventions to ensure the timing and effectiveness of education in territories at risk of adolescents’ antisocial behaviour. The ARTUR LAB are workshops that guide adolescents to think and act according to ethical and moral society principles. The activities are divided into ‘indoor’ and ‘outdoor’ modules and are built around sports, arts and active citizenship activities, all linked to the 4C risk prevention models (i.e., Countering, Treating, Coresponsible, Sharing) to transform crises into possibilities, poverty into opportunities and to educate adolescents to become responsible adults of tomorrow.
... Tale impatto negativo può essere ancor più grave per popolazioni «vulnerabili», come nel caso di genitori di bambini con disabilità. Infatti, il lockdown ha ulteriormente inasprito una condizione già di potenziale rischio, facendo sì che i genitori potessero contare su meno risorse nella gestione quotidiana dei loro bambini (Provenzi, Grumi e Borgatti, 2020;Provenzi, Baroffio, Ligabue e Borgatti, 2020). Alcuni recenti studi, suggeriscono che questi genitori hanno sperimentato durante il lockdown mancanza di aiuto e supporto e rilevanti preoccupazioni per il percorso terapeutico dei propri figli (Cacioppo et al., 2020) e hanno riportato accresciuti sintomi d'ansia a causa del rischio di contagio e delle preoccupazioni economiche (Faccioli et al., 2021). ...
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Il presente articolo presenta due studi riguardanti l’esperienza di lockdown durante l’emer- genza Covid-19 in genitori di bambini con disabilità. Il primo studio ha indagato, tramite un que- stionario online, l’impatto dell’emergenza sanitaria e dell’interruzione dei servizi di riabilitazione sul benessere di 84 caregiver. Le preoccupazioni per il bambino in seguito all’interruzione dei servizi ambulatoriali sono emerse come una delle maggiori problematiche affrontate dai caregiver ed erano significativamente associate ai loro livelli di stress genitoriale, ansia e depressione. Il secondo studio ha raccolto la valutazione di 36 genitori sull’esperienza del programma di tele- riabilitazione EnFORCE. I genitori hanno riportato benefici sia per i propri figli che per sé e limitate criticità tecniche nell’uso della tele-riabilitazione. Queste famiglie dovrebbero essere considerate come una popolazione ad alto rischio e l’investimento su programmi di tele-riabilitazione può ga- rantire loro continuità di cura e assistenza.
... Further longitudinal research is needed to assess the development of maternal affective problems during the post-partum period and their potential effects on the infant. Moreover, potential psychological and biological moderators and mediators should be investigated (56)(57)(58). The promotion of maternal mental health should be pursued and promoted during and after the COVID-19 pandemic (59) and may serve the double scope of supporting maternal mental health and preventing detrimental consequences for the growth and development of infants during the first year of life (10). ...
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The COVID-19 pandemic is a collective trauma that is threatening citizens’ mental health resulting in increased emotional stress, reduced social support, and heightened risk for affective symptoms. The present study aimed to investigate the effects of antenatal pandemic-related emotional stress and perceived social support on the symptoms of depression and anxiety of mothers who were pregnant during the initial COVID-19 outbreak in northern Italy. A sample of 281 mothers was enrolled at eight maternity units in the first hotspot region of the COVID-19 outbreak in northern Italy. Participants filled out online questionnaires assessing the direct or indirect exposure to the SARS-CoV-2 virus, pandemic-related stress, perceived social support, as well as symptoms of depression and anxiety. Depressive and anxious symptomatology was above clinical concern, respectively, in 26 and 32% of the respondents. Mothers who reported no exposure to SARS-CoV-2 during pregnancy and those who reported at least one direct or indirect exposure did not differ in terms of affective symptoms. Continuous scores and risk for severe depression and anxiety were positively associated with prenatal pandemic- related emotional stress and negatively linked with perceived social support during pregnancy. Women who become mothers during the COVID-19 emergency may be at high risk for affective problems. Dedicated preventive programs are needed to provide adequate preventive support and care for maternal mental health during and after the COVID-19 pandemic.
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Objective This study examined the impact of the COVID-19 pandemic on a national sample of adolescents and young adults (AYA) with spina bifida (SB) and parents of youth with SB. Methods AYA with SB (15–25; n = 298) and parents of children with SB (n = 200) were recruited to complete an anonymous, online survey in English or Spanish. Participants provided information about demographic and condition characteristics, as well as their technology access and use for behavioral health care. They also completed the COVID-19 Exposure and Family Impact Survey (CEFIS), which includes Exposure, Impact, and Distress subscales. Exploratory correlations and t-tests were used to examine potential associations between CEFIS scores and demographic, medical, and access characteristics. Qualitative data from the CEFIS were analyzed using thematic analysis. Results Scores on the Exposure, Impact, and Distress subscales demonstrated significant variability. Demographic associations with Exposure differed for those with higher Impact and Distress (e.g., White, non-Hispanic/Latino AYA reported higher rates of exposure [p = .001]; AYA who identified with a minoritized racial/ethnic identity reported greater impact [p ≤ .03]). Impacts to mental and behavioral health (n = 44), interference with medical care (n = 28), and interpersonal challenges (n = 27) were the most commonly occurring qualitative themes. Conclusions The current findings implicate differential impacts to individuals with SB and their families based on demographic, medical, and systemic factors (e.g., minoritized status). Recommendations to support families with SB and other pediatric conditions are made.
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Background: In January 2020, the coronavirus disease 2019 (COVID-19) started to spread in Italy. The Italian government adopted urgent measures to hold its spread. Enforcing compliance to such measures is crucial in order to enhance their effectiveness. Engaging citizens′ in the COVID-19 preventive process is today urgent in Italy and around the world. However, to the best of our knowledge, no previous studies have investigated the role of health engagement in predicting citizens compliance to health emergency containment measures. Method: An online survey was administered between February 28th and March 4th 2020 on a representative sample of 1000 Italians. The questionnaire included a measure of Health Engagement (PHE-S) and a series of ad hoc items intended to measure both affective and behavioral responses of the citizens to the emergency in terms of perceived susceptibility to and severity of the disease, orientation towards health management, change in habits and in purchases. To investigate the relationship between Health Engagement and these variables, a series of ANOVAs, Logistic regressions and crosstabs have been carried out. Results: Less engaged people show higher levels of perceived susceptibility to the virus and of severity of the disease; they trust less scientific and healthcare authorities, they feel less self-effective in managing their own health - both in normal conditions and under stress - and are less prone to cooperate with healthcare professionals. Low levels of Health Engagement are also associated with a change in the usual purchase behavior. Conclusions: The Patient Health Engagement Model (PHE) provides a useful framework for understanding how people will respond to health threats such as pandemics. Therefore, intervention studies should focus on particular groups and on raising their levels of engagement to increase the effectiveness of educational initiatives devoted to promote preventive behaviors.
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Since the first cases, the coronavirus disease (COVID-19) rapidly spread around the world, with hundred-thousand cases and thousands of deaths. Post-traumatic stress disorder (PTSD) is a common consequence of major disasters. Exceptional epidemic situations also promoted PTSD in the past. Considering that humanity is undergoing the most severe pandemic since Spanish Influenza, the actual pandemic of COVID-19 is very likely to promote PTSD. Moreover, COVID-19 was renamed severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2). With a poor understanding of viruses and spreading mechanisms, the evocation of SARS is generating a great anxiety contributing to promote PTSD. Quarantine of infected patients evolved to quarantine of 'infected' towns or popular districts, and then of entire countries. In the families of cases, the brutal death of family members involved a spread of fear and a loss of certainty, promoting PTSD. In the context of disaster medicine with a lack of human and technical resources, healthcare workers could also develop acute stress disorders, potentially degenerating into chronic PTSD. Globally, WHO estimates 30-50% of the population affected by a disaster suffered from diverse psychological distress. PTSD individuals are more at-risk of suicidal ideation, suicide attempt, and deaths by suicide - considering that healthcare workers are already at-risk occupations. We draw attention towards PTSD as a secondary effect of the SARS-Cov-2 pandemic, both for general population, patients, and healthcare workers. Healthcare policies need to take into account preventive strategy of PTSD, and the related risk of suicide, in forthcoming months.
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The coronavirus disease 2019 represents an unprecedented threat to human health worldwide. In the absence of a specific available cure for this disease, countries are adopting mitigation strategies that largely depend on physical distancing, with a dramatic restriction of social contacts. Whereas the psychological burden related to the coronavirus disease 2019 pandemic is starting to be well characterized by population-based surveys, we would like to capitalize from infant research evidence about the potentials of psychological reparation for human trauma and disconnection. Reparation can be defined as the human ability to coregulate emotions and to resolve interactive mismatches and separations by reciprocally engaging in attuned interactive exchanges capable of expanding our capacities for resilience. Alongside economical and medical health solutions, investing in psychological, emotional, and affective reparatory acts is warranted to be a key component of the recovery strategies worldwide. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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A series of unexplained pneumonia appeared in Wuhan, Hubei Province, China, which is highly contagious. The virus is prone to nervous and anxious psychological reactions. In the objective environment of complex and densely populated hospitals, it is a high-risk area for virus-transmitted infections and children generally have lower immunity who are more likely to develop infections. The results showed that the mental health problems of parents of hospitalized children during the epidemic were more serious, and the anxiety and depression were more obvious.
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During times of public crises, governments must act swiftly to communicate crisis information effectively and efficiently to members of the public; failure to do so will inevitably lead citizens to become fearful, uncertain and anxious in the prevailing conditions. This pioneering study systematically investigates how Chinese central government agencies used social media to promote citizen engagement during the COVID-19 crisis. Using data scraped from ‘Healthy China’, an official Sina Weibo account of the National Health Commission of China, we examine how citizen engagement relates to a series of theoretically relevant factors, including media richness, dialogic loop, content type and emotional valence. Results show that media richness negatively predicts citizen engagement through government social media, but dialogic loop facilitates engagement. Information relating to the latest news about the crisis and the government's handling of the event positively affects citizen engagement through government social media. Importantly, all relationships were contingent upon the emotional valence of each Weibo post.
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The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has already taken on pandemic proportions, affecting over 100 countries in a matter of weeks. A global response to prepare health systems worldwide is imperative. Although containment measures in China have reduced new cases by more than 90%, this reduction is not the case elsewhere, and Italy has been particularly affected. There is now grave concern regarding the Italian national health system's capacity to effectively respond to the needs of patients who are infected and require intensive care for SARS-CoV-2 pneumonia. The percentage of patients in intensive care reported daily in Italy between March 1 and March 11, 2020, has consistently been between 9% and 11% of patients who are actively infected. The number of patients infected since Feb 21 in Italy closely follows an exponential trend. If this trend continues for 1 more week, there will be 30 000 infected patients. Intensive care units will then be at maximum capacity; up to 4000 hospital beds will be needed by mid-April, 2020. Our analysis might help political leaders and health authorities to allocate enough resources, including personnel, beds, and intensive care facilities, to manage the situation in the next few days and weeks. If the Italian outbreak follows a similar trend as in Hubei province, China, the number of newly infected patients could start to decrease within 3–4 days, departing from the exponential trend. However, this cannot currently be predicted because of differences between social distancing measures and the capacity to quickly build dedicated facilities in China.
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Objectives: Parental posttraumatic stress disorder (PTSD) increases children's risk for emotional and behavioral problems. We examined parenting stress and parenting behavior quality as mediators of the relation between maternal PTSD and problematic child behaviors in a sample at high risk for trauma exposure. We also examined whether child sex moderated this association. Method: Participants were 141 African American mother-child dyads (children aged 8-12). Mothers reported PTSD severity, parenting stress, and child behavior (externalizing, internalizing, and emotional self-control). Parenting behavior quality (accounting for factors including parental warmth and engagement) was assessed from an observational parent-child interaction task. Results: Parenting stress, but not observed parenting behavior quality, mediated the relation between maternal PTSD severity and child behaviors. Child sex moderated this association, such that the effect was stronger for girls. Conclusions: Maternal PTSD may be associated with negative child behavior outcomes, and this relation appears to be mediated by increased parenting stress. Stress-reducing interventions for parents with PTSD could improve child outcomes, especially for girls. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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According to the concept of the Life Script, developed by Eric Berne, the fate of each individual is sketched in the early years of life. The subdivision of Child Ego State, known as Adult in the Child or Little Professor, is responsible for decoding the world throughout intuition and analogical thought and, thus, in one way or another, having physical and emotional survival guaranteed. The purpose of this article is to qualify and recognise the Adult in the Child and its relevance in the construction of personality trait, by studying the anatomical, physiological and emotional scenario in which the Adult in the Child develops itself. The author suggests that the peculiar stamina and wisdom held in the Adult in the Child may be present in adult life in a positive manner, even if the events that structured it were dramatic.
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The application of behavioral epigenetics’ principles (e.g., DNA methylation) to the study of human infants’ development has mainly focused on the effects of early adverse exposures, paying less attention to protective caregiving experiences. The present review focused on DNA methylation linked to variations in maternal behavior in human infants and children. Literature search occurred on three databases (PubMed, Scopus, and Web of Science) and eleven records were selected. Key variables were abstracted from each article including: sample size and characteristics, time and type of maternal caregiving behavior exposure, time and locus of methylation biomarker, presence/absence, time and type of adverse exposure. Six out of eleven records documented the predictive effect of maternal caregiving on DNA methylation, whereas the remaining five reported on the role of maternal behavior as an influencing factor of the adversity‐to‐methylation link. Consistent with evidence from the animal model, the quality of maternal caregiving in humans (a) might be associated with variations in DNA methylation status of specific genes involved in socio‐emotional development and (b) might partially buffer the association between early adversities and epigenetic variations in infants and children. Current evidence suggests that the quality of maternal caregiving can contribute to behavioral development trajectories of human infants and children at least partially through epigenetic regulation. Open questions and methodological aspects are discussed to guide future human developmental research in behavioral epigenetics. This article is protected by copyright. All rights reserved. Variations in maternal caregiving contribute to human infants' epigenetic regulation of stress‐related genes.