Maternal Mental Health
Maternal mental health was assessed using the following brief measures
(1) The Cohen Perceived Stress Scale (PSS-4; Lee, 2012), (2) Maternal
General Anxiety Disorder Scale; (GAD-2, Donker et al., 2011), and (3)
The Patient Health Questionnaire (PHQ-2,
(Löwe et al., 2005) that measures
depression, prior to and during COVID-19 (Table 1). The PSS-4 consists
of 4 items on a Likert-type scale ranging from 0 (never) to 4 (fairly
often). Summed scores are computed and range from 0 to 16. The GAD-2 and
PHQ-2 consist of 2 items assessed on a Likert-type scale ranging from 0
(not at all) to 3 (nearly every day), with summed scores ranging from 0
to 6. Maternal mental health cut-offs were determined for anxiety and
depression (GAD-2 and PHQ-2) as a value of three or above, as a probable
anxiety disorder and high probability of major depressive disorder,
respectively (Donker et al., 2011; Löwe et al., 2005). The cut-off value
for maternal stress was also a three or above, as it was found to be the
average score in a large-scale study of Canadian families (Muhammad &
Gagnon, 2010).