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).