Caregiver Perceptions of Children's Psychosocial Functioning During the Stringent COVID-19 Lockdown Restrictions in Shanghai: Cross-sectional Study (Preprint)

BACKGROUND The global pandemic and resulting government responses have led to abrupt changes to families’ daily lives, and mental health of children and adolescents. Shanghai municipal implemented a “dynamic zero-COVID” policy in 2022 to eliminate a wave of COVID-19 infection. OBJECTIVE To examine caregiver-reported changes in the learning, exercise and interactions of their children, as well as psychosocial problems, associated with COVID-19 exposure and understand impact of stringent lockdown policies on parenting and psychosocial functioning of children and adolescents. METHODS In this cross-sectional study, an anonymous survey was distributed via online QR codes in the period May 5–20, 2022 in Shanghai, China. Only data from caregivers aged >20 years with Shanghai Internet protocol addresses and a child or adolescent currently in the home were included. The outcomes were psychosocial functioning in children and adolescents, as reported by parents using the Pediatric Symptom Checklist-17 (PSC-17). COVID-19 exposure and life changes were also reported by caregivers. Multivariate logistic regression was used to analyze risk factors for poor psychosocial functioning. RESULTS In total, 2,493 valid questionnaires were analyzed. The rate of positive scores on the global PSC-17 scale was 16.5%. The internalizing, attention, and externalizing problem subscale positivity rates were 17.3%, 10.9%, and 8.9%, respectively. Caregivers reported that 64.2% and 20.7% of the children’s interactions with friends/peers and parents deteriorated, respectively. Younger children, more COVID-19 exposure, screen times for >3 hours per day, shorter exercise, worse sleep, deteriorated interactions with friends/peers and parents were risk factors for poor psychosocial functioning. CONCLUSIONS The prevalence of psychosocial problems among children and adolescents is relatively high. It is necessary for governments, communities, schools, and families to take appropriate countermeasures to reduce the negative impact of the stringent COVID-19 pandemic on caregivers’ parenting of their children and psychosocial functioning of children and adolescents.