Correlations of Parenting Styles and Family Support with Mental Health Amid COVID-19 Remote Learning

This study aimed to investigate the mental health of children and caregivers during the period of remote learning amid the level 3 COVID-19 pandemic alert (May to July, 2021), exploring the correlations of perceived family support/parenting style with mental health, moderating effects of attention-deficit/hyperactivity disorder (ADHD), and mediating effects of remote learning on these associations. We recruited a total of 265 parent-child dyad [97 children had ADHD, 17 had autism spectrum disorder, 15 had developmental delays or intellectual disabilities and 136 were neurotypical children (NT)] from the child psychiatric and pediatric outpatient clinics and the child development center of a medical center. Caregivers provided demographic information and completed questionnaires assessing the anxiety and depression of children and themselves, parenting styles and perceived family support during the remote learning period. To ensure comparability, a matched subset of 65 ADHD and 65 NT children matching for age and sex was analyzed. We found caregivers and children had clinically significant anxiety/depressive symptoms in ADHD and NT subgroups, and caregivers in the ADHD group reported higher anxiety levels, less affectionate parenting, and lower perceived family support compared to those in the NT group. Affectionate parenting was associated with fewer children’s depressive symptoms. Also, significant ADHD-by-family support interactions were noted in their associations with caregivers’ anxiety/depression. Family conflicts mediated the association between ADHD and children’s anxiety/depression during the period of remote learning. Our report highlights the complex relationships between ADHD, perceived family support, and the mental health of caregivers during challenging situations like COVID-19 pandemic. Correlations between children’s and caregivers’ anxiety were stronger in the ADHD group than in the non-ADHD group. Family support was related to caregivers’ mental health more in children with ADHD than children without ADHD. Authoritarian parenting was related to increased depressive symptoms in children without ADHD more than children with ADHD. Family conflicts and irregular routines mediated the link of ADHD and children’s anxiety/depressive symptoms. Cross-sectional design and recall bias preclude attributing psychological distress definitively to ADHD or the pandemic.