Table 5.

Characteristics of included studies examining factors associated with family violence during the pandemic (n=9).

Authors, Year, Country	Objective and Hypotheses	Participants and study design	Type of violence	Measures	Main results
Bérubé, et al., 2020,61 Canada.	“To examine parents’ reports on the response their children received [from them] to their needs during the COVID-19 crisis”.61(p1)	Parents of children aged 0 and 17 years (n=414). Cross-sectional.	Neglect.	Cognitive and Affective Needs scale, the Security Needs scale, and the Basic Care Needs scale.	Parents with high levels of parental stress related to parent-child interactions associated with changes required to manage COVID-19 protocols (e.g. masking) also reported less response to their child's cognitive and affective needs than those with lower levels of parental stress (F (1,317) = 23.4, p 4.59, SD = 0.46, respectively).
Calvano, et al., 2021,62 Germany.	“To generate representative data on pandemic-related stress, parental stress, parental subjective and mental health, and the occurrence of adverse childhood experiences (ACEs) and to describe risk factors for an increase in ACEs”.62(p1)	Parents of underage children (n=1024). Cross-sectional.	Verbal emotional abuse, physical abuse, emotional neglect, nonverbal emotional abuse, and children witnessing DV.	Pandemic Stress Scale, the Parental Stress Scale, general stress, patient mental health, subjective health, ACEs, and positive and negative experiences during the pandemic.	6.5% (n=66) of parents reported on their children's lifetime occurrence of severe stressful life experiences including violence, abuse, or neglect. Of these, 34.8% reported an increase in occurrence during the pandemic (17.6% no change, 47.5% decrease). The highest lifetime ACE occurrence was reported for children witnessing DV (n=332, 32.4%) and for verbal emotional abuse against the children (n=332, 32.4%). There were few reports of sexual abuse (n=14) and physical neglect (n=11). Across the subtypes, 27.1–46.2% of cases reported no change in occurrence and that in 11.6−34.3% of cases, a decrease was reported. 48.4% of the families with job losses during the pandemic reported an increase in witnessing DV (p=0.013), and 62.1% reported an increase in verbal emotional abuse (p=0.024). In families reporting significant financial losses during the pandemic, 53.0% reported an increase in verbal emotional abuse (p=0.021).
Chung, et al., 2020,63 Singapore.	“To yield better understandings of the effects of COVID-19 on parents and their parenting”.63(p4)	Parents at least 18 years old, who lived in Singapore as citizens or permanent resisdents with at least one child 12 years or younger (n=258). Cross-sectional.	CA, verbal emotional abuse, physical abuse, and emotional abuse.	Coronavirus Impacts Questionnaire (financial impact, resource impact, and psychological impact), the Parental Stress Scale, and parenting outcomes (harsh parenting behaviors and parent-child relationship closeness).	Parents who were more impacted by COVID-19 experienced more parenting stress (b=.22, p<.001) than those who felt they were less impacted by COVID-19, and parents who experienced more parenting stress indicated that they had used more harsh parenting (b=2.63, p< .001).
Lawson, et al., 2020,64 United States.	To investigate “factors associated with child maltreatment during the COVID-19 pandemic, including parental job loss, and whether cognitive reframing moderated associations between job loss and child maltreatment”.64(p1)	Parents of 4 to 10-year-olds recruited from Facebook ads and from Amazon Mechanical Turk (n=342). Cross-sectional.	Psychological maltreatment and physical abuse.	The Conflict Tactics Scale Parent-Child version (CTSPC) was used to determine whether parents psychologically maltreated and physically abused their children within the past year and within the past week during the COVID-19 pandemic.	Parents who lost their jobs (OR =4.86, CI95%: [1.19, 19.91], p =.03) and were more depressed (OR =1.05, CI 95% [1.02, 1.08], p <.01) were more likely to psychologically maltreat during the pandemic.
Lee, et al., 2021,65 United States.	To examine “the association of parents’ perceived social isolation and recent employment loss to risk for child maltreatment (neglect, verbal aggression, and physical punishment) in the early weeks of the pandemic”.65(p1)	AParents with at least one child living at home between the ages of 0–12 years (n=555). Cross-sectional.	Physical, verbal, and emotional neglect/abuse.	CTSPC items were used to assess risk for physical neglect, emotional neglect, verbal aggression, and physical abuse. To measure increases in parental neglect and discipline since COVID-19, parents were asked to report: “Since approximately 2 weeks ago, when the Coronavirus/COVID-19 global health crisis began:” “I have increased the use of discipline with my child(ren)”; “I have yelled at/screamed at my child(ren) more often than usual”; “I have had more conflicts with my child(ren) than usual”; “I have had to leave my child(ren) home alone more often than usual” and “I have spanked or hit my child(ren) more often than usual” (0=no, 1=yes, 2=not applicable).	A one unit increase in parental perceived social isolation was associated with a 71% increase in the odds of parents physically neglecting their children; an 84% increase in the odds of emotional neglect; a 103% increase in the odds of shouting, yelling, or screaming; a 55% increase in the odds of parents using more discipline; a 77% increase in the odds of parents yelling or screaming at their child(ren) more often than usual; a 92% increase in the odds of parents having more conflicts with their child(ren)than usual; a 132% increase in the odds of parents leaving their child alone more often than usual; and a 124% increase in the odds of spanking or hitting a child(ren) more often than usual. Experiencing an employment change was associated with a 151% increase in the odds of emotional neglect and with a 275% increase in the odds of spanking or slapping.
Manja, et al., 2020,42 Malaysia.	“To discover the impact of parental burnout during Movement Control Order”.42(p5)	Parents that were affected by Movement Control Order 2020 due to the COVID-19 pandemic (n=158). Cross-sectional.	Neglect, verbal violence, and physical violence.	Parental Burnout Inventory including assessment of parental burnout, neglect and violence	Parental burnout significantly associated with neglect and violence. (p<0.001).
Pinchoff, et al., 2021,66 Kenya.	“To assess the short-term economic, social, and health effects of COVID-19 and related mitigation measures among a prospective, longitudinal cohort of households sampled from five of Nairobi's informal settlements, with a focus on disproportionate burden placed on women”.66(p3)	Households across five informal settlements in Nairobi, sampled from two previously interviewed cohorts (n=2009). Prospective longitudinal cohort.	Arguing, tension, household violence, or fear that partner would harm them due to COVID-19.	Questions regarding social and economic effects on households, for example, loss of employment, skipping meals, household costs, and gender-based violence or tensions experienced in the household.	In May, households reported more tension, arguing, violence, or fear that partners would harm them. In fully adjusted models, women, married and/or cohabiting couples, and those who reported lost income were more likely to report concerns regarding household tension and violence.
Wong, et al., 2021,67 China.	“To investigate whether job loss, income reduction, and parenting affect child maltreatment”.67(p1)	Randomly sampled parents aged 18 years or older who had and lived with a child under 10 years old in Hong Kong between May 29 to June 16,2020 (n=600). Cross-sectional.	Physical and emotional abuse.	The CTSPC was used to determine psychological aggression, nonviolent disciplinary behaviors (corporal punishment), severe physical assault, and very severe physical assault.	Income reduction was significantly associated with severe (OR = 3.29,95% CI = 1.06, 10.25) and very severe physical assaults (OR = 7.69, 95% CI = 2.24, 26.41) towards children. Job loss or large income reduction were also significantly associated with severe (OR= 3.68,95% CI = 1.33, 10.19) and very severe physical assaults (OR = 4.05, 95% CI = 1.17, 14.08) towards children. Income reduction (OR = 0.29, 95% CI = 0.15, 0.53) and job loss (OR = 0.47,95% CI = 0.28, 0.76) were significantly associated with less psychological aggression. Exposure to IPV between parents was significantly associated with all types of child maltreatment. Having higher levels of difficulty in discussing COVID-19 with children was significantly associated with more corporal punishment (OR = 1.19, 95% CI = 1.05,1.34), whereas having higher level of confidence in managing preventive COVID-19 behaviors with children was negatively associated with corporal punishment (OR = 0.87, 95% CI = 0.76, 0.99) and very severe physical assaults (OR = 0.74, 95% CI = 0.58, 0.93).
Xu, et al., 2020,68 United States.	“To examine (1) the relationships between parenting stress, mental health, and grandparent kinship caregivers’ risky parenting practices, such as psychological aggression, corporal punishment, and neglectful behaviors towards their grandchildren during the COVID-19 pandemic, and (2) whether grandparent kinship caregiver's mental health is a potential mediator between parenting stress and caregivers psychological aggression, corporal punishment, and neglectful behaviors”.68(p1)	Grandparent kinship caregivers (n=362). Cross-sectional.	Physical and emotional abuse and neglect.	Psychological aggression, corporal punishment, and neglectful behaviors were measured through the CTSPC. Child and grandparent Kinship caregivers’ characteristics. Mental health via Mental Health Inventory-5 scale. Parenting stress via the Parent Stress Index.	Grandparent kinship caregivers’ high parenting stress and low mental health were associated with more psychological aggression, corporal punishment, and neglectful parenting behaviors during COVID-19. Grandparent kinship caregivers’ mental health partially mediated the relationships between parenting stress and their psychological aggression, corporal punishment, and neglectful behaviors.

Note: (S)CAN = (Suspected) Child Abuse and Neglect; CA = Child Abuse; CPA = Child Physical Abuse; CTSPC = Conflict Tactics Scale Parent-Child; DV = Domestic Violence; IPV = Intimate Partner Violence.