When the first U.S. case of COVID-19 due to community spread was diagnosed in late February 2020, it set off a rapid series of events. As cases surged, many states issued stay-at-home orders, and schools and childcare centers shut down. With such rapid, widespread disruption, it’s no wonder that many found themselves struggling with fear and anxiety. 

Unfortunately, these emotions may trigger adverse effects on the body and mind. Previous studies have linked fear with depressed immune system functioning, cardiovascular problems, and long-term mental health issues like post-traumatic stress disorder. And in a pandemic, these repercussions could be even more harmful than usual. 

James Dillard, distinguished professor of communication arts and sciences, said people use a variety of strategies to cope with their fear in situations like this. While he is not currently studying fear during the coronavirus pandemic, he did research on how pregnant women dealt with fear during the 2015 Zika epidemic, which posed an extra threat to babies in utero.

One strategy Dillard and his team investigated was “avoidance,” where people try to manage fear by avoiding a topic altogether, such as turning off the TV and not talking about it. This did not reduce fear for the participants in the study. A second strategy was called “contesting,” which means denying the problem exists or that it was being blown out of proportion. This also was ultimately ineffective. 

“One of the most surprising things we found was in regard to the suppression of emotions,” Dillard said. “There’s this idea that you can say ‘I know I'm feeling this, but I'm going to push it down and ignore it,’ but people who do that actually experience more fear. It's very counterproductive and something to avoid.”

While media coverage can be overwhelming or frightening, Dillard said it is still important to stay up to date with the latest recommendations from public health officials and other experts. To stay informed while minimizing fear, he recommends creating a plan for how much and what kind of media you consume.

“If you feel consistently uncomfortable or are unable to sleep, it may be best to back off the media,” Dillard said. “It's also important to choose media sources carefully. There are some outlets that actively try to increase your fear, but fortunately, they're not that hard to avoid.”

Expecting during the pandemic

Other researchers across the University are exploring how fear, uncertainty and other psychological stresses due to the COVID-19 pandemic are affecting individuals and families.

In a project funded by a seed grant from the Huck Institutes of the Life Sciences, Aleksandra Zgierska, family medicine and addiction medicine physician at Penn State College of Medicine, is leading research to discover how the coronavirus pandemic is affecting pregnant and postpartum women in central Pennsylvania. 

“The pandemic could be affecting these women in a couple different ways,” said Jessica Wright, project manager for the team. “It could be the risk from the COVID-19 infection itself, or it could be social distancing requirements and other restrictions that may lead to job and food insecurity or contribute to domestic abuse. And of course, heightened anxiety about the child’s health due to COVID-19 exposure may also impact the women’s well-being and mental health.” 

Asking women themselves about their experiences can help better understand the pandemic’s impact, the researchers said. Interestingly, experiences may be both positive and negative. 

“My husband has been working from home the majority of the past six months so that has been a huge blessing,” reported one participant. “He's been able to help with my transition back to full time work. [At the same time,] I mourn the loss of the experiences I thought I would have during my maternity leave, not being able to spend time with friends and family and not being able to share the joys of the first months of my son's life with anyone else.”

The research team will use a survey and screening tool to identify pregnant women who are experiencing risk factors such as depression, substance misuse, or anxiety, that could lead to adverse outcomes such as premature birth or potential difficulties due to loss of income, isolation from support systems, and other stresses. These women will then be provided with a personalized list of resources or a link to a Penn State Health clinic where they can then schedule an online or in-person appointment with a clinician.

As a pregnant woman herself, Wright knows firsthand how difficult it can be expecting a child during a pandemic. She said that while it’s always important to make healthy choices during pregnancy, making those choices is more stressful now than ever.

“Each decision I make is weighed against the potential impact of becoming COVID-positive on my older children and the baby, too,” she said.

“Pregnancy and child birth can bring joy but also add complexity and stress to our lives,” said Zgierska. “The pandemic has heightened that stress among expectant mothers and families who now worry about impacts on pregnancy, mother and child health, and family well-being. We need to actively support pregnant women, new mothers, and their families so that families and children can thrive.”

Too much of a good thing?

Another Huck seed grant focuses on how the pandemic might influence family dynamics. From stay-at-home orders that were issued in the early spring, to the recognition that their children will be educated at least partially through remote learning, many families have been spending an unprecedented amount of time with each other. While this has some benefits, it can also aggravate existing strains and create new ones.

Mark Feinberg, research professor of health and human development at Penn State, said families may face a range of stressors during the pandemic. When lockdown orders went into effect across the country, many people were suddenly unemployed or on furlough, without a steady income in an already tumultuous time. Feinberg said it's hard to overestimate the stress this can bring to an individual, let alone a family.

“There’s a lot of research that shows financial stress translates into more family conflict and aggression, harsh parenting, and even child abuse,” he said. “This stress affects how calm, patient and supportive a parent can be. Research from previous times of widespread economic stress shows how detrimental it can be for families, parenting and ultimately for kids' well-being.”

The parent-child relationship is not the only one within many households. There are also relationships between siblings. While sibling roughhousing and teasing are sometimes written off as harmless, Feinberg said these relationships can sometimes become high-conflict and even abusive, with effects lasting into adulthood. 

He added that sibling relations can have almost as much of an influence on children's lifelong well-being, mental health, social competence and quality of romantic relationships, as parenting.

“There’s a lot of jealousy, rivalry, physical aggression and other dimensions of conflict that go on in some — but not all — sibling relationships,” Feinberg said. “And while some researchers are working in the field of sibling relations, there’s still not a lot of understanding about how to deal with the more violent aspects of sibling relationships."

Feinberg said that while he and other researchers can use their previous work to predict how the pandemic is affecting families, there is still a lot they do not know. He recently received COVID-19 seed grant funding to study the effects of the pandemic on two groups of families that the researchers have been studying for several years. 

“We’re hoping to survey these families several times during the pandemic and over the next few years to examine how lockdowns and other changes to daily life initially disrupted their lives and how they’re adjusting over time,” Feinberg said. 

One of the groups being studied is part of a randomized trial of Family Foundations, a program developed by Feinberg that helps expecting couples build a strong, supportive parenting team with a series of brief sessions both prior to and after the birth of their child.

According to Feinberg, the program is based on the idea that a solid coparenting relationship — one that is built on teamwork and mutual support — is one of the fundamental bases of family well-being. So far, the study has found that parents who have gone through the program tend to be less stressed, less depressed and less anxious than parents who have not, and as a result are more patient and less harsh with their children.

And, Feinberg said, they may be weathering the COVID-19 pandemic better.

“Our initial results are suggesting that during the pandemic, those Family Foundations families are also doing better, relative to other families,” he said. “This family support and prevention approach appears to have long-term benefits, even in this unexpected and acutely stressful situation.”

While the pandemic has put unprecedented stress on nearly everyone, Feinberg said it is still possible to find a silver lining in what is an incredibly tough situation. In normal times, many families are operating under busy schedules, and the pandemic may have given them an unexpected gift — time.

“Despite the stress and hardships, I hope that families can also enjoy their time together,” Feinberg said. “If families are finding themselves spending more time together, I’m hoping they can have less distractions and more opportunities to play games, enjoy each other, and do things together that they normally wouldn’t.”

Editor's note: This story appears in the Spring issue of Research/Penn State magazine.