{
  "abstract": "Objective Mothers’ mental health and life satisfaction may have been negatively affected due to challenges during the COVID-19 pandemic. Given the risk of future crises, knowledge of possible mitigating factors in this population is essential. This study aims to examine whether the pandemic affected the level of protective factors such as social support, physical activity and employment situation, and how these factors are associated with mental distress and life satisfaction.Design Longitudinal cohort study.Outcome measures Primary outcomes were mental distress (measured by the eight-item version of the Hopkins Symptom Checklist) and life satisfaction (measured by the Satisfaction With Life Scale). As the first step, we investigated changes in the levels of social support (defined by the number and frequency of social contact), physical activity (average hours of physical activity during a week), employment situation (actively working vs sick leave or unemployed), alcohol consumption (measured by the Alcohol Use Disorders Identification Test-Consumption) and relationship satisfaction (measured by the five-item version of the Relationship Satisfaction Scale).Methods We analysed data from two waves of the Norwegian Mother, Father and Child Cohort Study (n=~18 000 mothers); one pre-pandemic wave and one wave where half of the sample responded after the onset of the pandemic, with pandemic exposure being defined by questionnaire response timing rather than cohort recruitment. To assess changes in protective factors over time and pandemic exposure, we used difference-in-differences analyses and regression discontinuity design. Associations between protective factors with mental distress and life satisfaction, and possible moderation by pandemic exposure, were investigated using multiple regression models with interaction terms adjusted for potential confounders.Results Apart from physical activity, which declined less across time in the pandemic group (B=0.09, 99% CI 0.05 to 0.12), protective factors did not change during the pandemic. Social support, employment situation and relationship satisfaction were associated with mental distress and life satisfaction, whereas physical activity showed a unique relationship with mental distress. Most associations were similar across pandemic exposure groups, except employment situation which appeared to have a stronger protective effect in the pandemic group (β=−0.12, 99% CI −0.24 to −0.00).Conclusions Changes over time in self-reported levels of protective factors were generally consistent among mothers independent of the pandemic. These factors appear to play an equally important role for mental distress and life satisfaction both under ordinary circumstances and during public health crises. Our findings enhance the understanding of how potential protective factors among mothers are associated with mental distress and life satisfaction in the context of a global stressor. Future studies should investigate additional mitigating factors that may be particularly relevant during global crises and explore the causal relationship between protective factors, mental health and life satisfaction.",
  "authors": [
    {
      "affiliations": [
        "PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway",
        "Department of Psychology, University of Oslo, Oslo, Norway"
      ],
      "name": "Pia Myklebust Johannessen"
    },
    {
      "affiliations": [
        "Department of Disease Burden, Norwegian Institute of Public Health, Bergen, Norway",
        "Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway"
      ],
      "name": "Christian Madsen"
    },
    {
      "affiliations": [
        "Department of Health Management and Health Economics, University of Oslo, Oslo, Norway",
        "Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway"
      ],
      "name": "Rannveig Kaldager Hart"
    },
    {
      "affiliations": [
        "PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway",
        "Department of Psychology, University of Oslo, Oslo, Norway",
        "Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway"
      ],
      "name": "Ingunn Olea Lund"
    },
    {
      "affiliations": [
        "PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway",
        "Department of Psychology, University of Oslo, Oslo, Norway"
      ],
      "name": "Johanne Hagen Pettersen"
    },
    {
      "affiliations": [
        "Department of Psychology, University of Oslo, Oslo, Norway",
        "Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway"
      ],
      "name": "Kristin Gustavson"
    },
    {
      "affiliations": [
        "Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway",
        "PROMENTA Research Center, University of Oslo, Oslo, Norway"
      ],
      "name": "Espen Røysamb"
    },
    {
      "affiliations": [
        "Division of Public Health and Prevention, Norwegian Institute of Public Health, Oslo, Norway"
      ],
      "name": "Ragnar Nesvåg"
    },
    {
      "affiliations": [
        "PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway",
        "Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway",
        "PROMENTA Research Center, University of Oslo, Oslo, Norway"
      ],
      "name": "Ragnhild Eek Brandlistuen"
    },
    {
      "affiliations": [
        "PsychGen Center for Genetic Epidemiology and Mental Health, Norwegian Institute of Public Health, Oslo, Norway",
        "Department of Child Health and Development, Norwegian Institute of Public Health, Oslo, Norway",
        "PROMENTA Research Center, University of Oslo, Oslo, Norway"
      ],
      "name": "Helga Ask"
    }
  ],
  "title": "Protective factors for maternal mental health and life satisfaction during the COVID-19 pandemic: a longitudinal analysis",
  "uid": "68378a2e-ded8-5e53-a518-0abd443c32d3"
}