Safe but Lonely? Loneliness, Anxiety, and Depression Symptoms and COVID-19

Effectiveness of a scalable, remotely delivered stepped-care intervention to reduce symptoms of psychological distress among Polish migrant workers in the Netherlands: study protocol for the RESPOND randomised controlled trial

BACKGROUND

The COVID-19 pandemic has negatively affected the mental health of international migrant workers (IMWs). IMWs experience multiple barriers to accessing mental health care. Two scalable interventions developed by the World Health Organization (WHO) were adapted to address some of these barriers: Doing What Matters in times of stress (DWM), a guided self-help web application, and Problem Management Plus (PM +), a brief facilitator-led program to enhance coping skills. This study examines whether DWM and PM + remotely delivered as a stepped-care programme (DWM/PM +) is effective and cost-effective in reducing psychological distress, among Polish migrant workers with psychological distress living in the Netherlands.

METHODS

The stepped-care DWM/PM + intervention will be tested in a two-arm, parallel-group, randomized controlled trial (RCT) among adult Polish migrant workers with self-reported psychological distress (Kessler Psychological Distress Scale; K10 > 15.9). Participants (n = 212) will be randomized into either the intervention group that receives DWM/PM + with psychological first aid (PFA) and care-as-usual (enhanced care-as-usual or eCAU), or into the control group that receives PFA and eCAU-only (1:1 allocation ratio). Baseline, 1-week post-DWM (week 7), 1-week post-PM + (week 13), and follow-up (week 21) self-reported assessments will be conducted. The primary outcome is psychological distress, assessed with the Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Secondary outcomes are self-reported symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), resilience, quality of life, and cost-effectiveness. In a process evaluation, stakeholders' views on barriers and facilitators to the implementation of DWM/PM + will be evaluated.

DISCUSSION

To our knowledge, this is one of the first RCTs that combines two scalable, psychosocial WHO interventions into a stepped-care programme for migrant populations. If proven to be effective, this may bridge the mental health treatment gap IMWs experience.

TRIAL REGISTRATION

Dutch trial register NL9630, 20/07/2021, https://www.onderzoekmetmensen.nl/en/trial/27052.

Moderation effects of loneliness between fatalism and wellbeing during the COVID-19 pandemic

The COVID-19 pandemic has put more than just our physical health at risk. Due to containment measures, people have become increasingly isolated and have drastically reduced their daily social interactions. Many studies have already shown the negative effects of these measures, including fatalism. However, research linking fatalism during COVID-19 to well-being indicators is still limited. The goal of this study is to examine the relationship between COVID-19-related fatalism and well-being indicators, as well as the role of loneliness in moderating this relationship. Data was collected from 1,036 adults in Peru through an online survey that included the Quality-of-Life Index, the Fatalism Facing COVID-19 Scale, the Loneliness Scale, and the Mood Assessment Scale. Three models were tested using linear regression and ordinary least squares with bias-corrected bootstrapping. The results indicate that fatalism has a negative impact on quality of life and a positive effect on negative affect, and loneliness moderates both relationships, supporting the conclusion that fatalism exacerbates the effect of well-being indicators and negative affect.

Pre- and Post-Pandemic (COVID-19) Mental Health of International Students: Data from a Longitudinal Study

Purpose

International students are highly vulnerable to the risk of mental health worsening before and during the pandemic (COVID-19). This study investigated international students' mental health pre- and post-pandemic (COVID-19).

Methods

It is a longitudinal study, and data were collected online, pre-pandemic (N = 470) and during the pandemic (N = 420). Using a random sampling technique, a self-administered questionnaire was used to measure mental health, including depression and anxiety.

Results

Findings show that international students' mental health was good in pre-pandemic. Meanwhile, international students were found to be more depressed and anxious during the pandemic. Findings also investigated that in the pre-pandemic phase, young students' and mainly females' mental health was worsened.

Conclusion

This study concluded that students' mental problems are alarming, so the university should provide psychological services for the student's mental health. Post-pandemic is leaving long-lasting psychological effects and will require further investigation.

The change in children's subjective relational social cohesion with family and friends during the COVID-19 pandemic: A multinational analysis

As a response to the COVID-19 pandemic, social-distancing measures have been implemented worldwide, including school closures. Previous studies indicated that children's relational social cohesion with family (RSC-Fa) and friends (RSC-Fr) may have decreased during the pandemic, but some children described that positive experiences were gained from the confinement measures of social distancing. Mostly, these studies are qualitative or capture a single country and have an exploratory character. Using data collected in 2021 of more than 20,000 children primarily aged 9-13 years as part of the International Children's Worlds COVID-19 Supplement Survey from 18 countries (Germany, Turkey, Bangladesh, Italy, Albania, Romania, Chile, Wales, Taiwan, Belgium, Algeria, Israel, Russia, South Korea, Indonesia, Estonia, Finland, and Spain), this study aimed to examine how the COVID-19 pandemic has affected children's RSC-Fa and RSC-Fr and explore the role of relational factors. RSC-Fa and RSC-Fr are measured through satisfaction in relationships with family members and friends before and during the COVID-19 pandemic, respectively. We employed descriptive statistics, cluster analysis, and multinomial logistic regression analysis. Our analyses confirmed the decrease in RSC-Fa and RSC-Fr, with a noticeably bigger decrease in RSC-Fr. Five profiles of change in RSC emerged: (1) gainers in both RSC; (2) gainers in RSC-Fa and decliners in RSC-Fr; (3) no change in either RSC; (4) decliners in RSC-Fa and gainers in RSC-Fr; and (5) decliners in both RSC. The quantity and quality of children's relationships differ by their profiles of change in RSC. For example, it was significantly more likely that "decliners in both RSC" had to be at home all day because of COVID-19 than "gainers in both RSC" or "no changers." Mainly, the quantity of relationship factors, and among different quality factors, only autonomy perceptions, help to explain the children belonging to the "gainers in both RSC" profile compared to the "no changers." Meanwhile, almost all the quantity and quality of relationships factors help to explain children's belonging to the "decliners in both RSC" profile compared to "no changers." In conclusion, our study confirmed the importance of keeping schools open to protect the RSC of children.

Impact of loneliness on health-related factors in Australia during the COVID-19 pandemic: A retrospective study

COVID-19 pandemic and its associated social and physical distancing restrictions may have had a severe impact on health. In the present study, we investigate the changes in physical, social and mental health, as well as the health literacy of Australians subsequent to the onset of COVID-19 pandemic, and examine the influence of loneliness on these health-related factors. Using a retrospective cross-sectional study design, 607 Australian adults completed a self-report online survey which assessed their health-related factors before and after onset of the COVID-19 pandemic (data collected between June 2020 to November 2020). Australians reported statistically significant increase in a number of (poorer) health-related factors (e.g., weight gain, sleeping difficulties, poor somatic health, higher loneliness, more issues navigating the healthcare system) post onset of COVID-19 pandemic. Further, after adjusting for covariates, higher loneliness during pandemic predicted poorer health-related outcomes (e.g., more somatic health complaints, poorer quality of diet, poorer social support for health). The COVID-19 pandemic and its associated social and physical distancing restrictions may have contributed towards poorer health-related factors among Australian adults. Further, increased loneliness during the pandemic may have further worsened physical health and health literacy outcomes among Australians.

University Teachers During the First Lockdown Due to SARS-CoV-2 in Italy: Stress, Issues and Perceptions of Misconduct

With the spread of the pandemic and the introduction of measures aimed at its containment, it is necessary to understand in specific national contexts how home quarantine has affected the psychophysical well-being of academics, and their ability to maintain integrity. To this end we constructed an online questionnaire to investigate the levels of stress, well-being, and work-life balance in relationship with living and working conditions. Moreover, the questionnaire was designed to obtain information about the perceived occurrence, increase or decrease of misconduct in research (e.g., research misconduct by colleagues) and professional relationships (e.g., misbehaviors between colleagues, from students and toward students). The questionnaire was administered online by contacting faculty at three universities in Tuscany, Italy, asking them to relate their experience during the first lockdown (March-May 2020). Faculty members were invited to complete the questionnaire by their institutional e-mail account. The final sample consisted of 581 respondents. The results showed that inadequacies of the equipment, and particularly poor internet connection, were significantly correlated with main issues reported, such as relationships with students and research activities. Female teachers primarily suffered from stressful conditions, lacked well-being, and experienced work-life imbalance. Stress levels were related to perceptions of the frequency of misconduct and of an increase in their frequency during the period of home quarantine. Female professors, when compared to their male counterparts, perceived misconduct from students as increased and more frequent in the period of quarantine. Results point to a gender issue that is likely to arise from conditions of domestic activities imbalance and that increases stress and misconduct perception.

Pre-pandemic Predictors of Loneliness in Adult Men During COVID-19

Loneliness is a major public health issue, with its prevalence rising during COVID-19 pandemic lockdowns and mandated "social distancing" practices. A 2020 global study (n = 46,054) found that, in comparison to women, men experienced the greatest levels of loneliness. Although research on predictors of loneliness during COVID-19 is increasing, little is known about the characteristics of men who may be particularly vulnerable. Studies using prospective data are needed to inform preventative measures to support men at risk of loneliness. The current study draws on rare longitudinal data from an Australian cohort of men in young to mid-adulthood (n = 283; aged M = 34.6, SD = 1.38 years) to examine 25 pre-pandemic psychosocial predictors of loneliness during COVID-19 social restrictions (March-September 2020). Adjusted linear regressions identified 22 pre-pandemic predictors of loneliness across a range of trait-based, relational, career/home and mental health variables. Given the extensive set of predictors, we then conducted penalized regression models (LASSO), a machine learning approach, allowing us to identify the best fitting multivariable set of predictors of loneliness during the pandemic. In these models, men's sense of pre-pandemic environmental mastery emerged as the strongest predictor of loneliness. Depression, neuroticism and social support also remained key predictors of pandemic loneliness (R 2 = 26, including covariates). Our findings suggest that men's loneliness can be detected prospectively and under varying levels of social restriction, presenting possible targets for prevention efforts for those most vulnerable.

Factors associated with depression and anxiety in the adult population of Qatar after the first COVID-19 wave: a cross-sectional study

There is limited data from Arabic-speaking countries on risk factors for depression and anxiety during the COVID-19 pandemic. Country-specific data is necessary given differences in culture, demographics, and COVID-19 infection and mortality rates. The main purpose of the study is to identify the factors associated with symptoms of depression-anxiety in the adult population of Qatar during the first year of the COVID-19 pandemic. We conducted a cross-sectional online survey in Qatar between July and December 2020 after Qatar’s first COVID-19 wave and before the beginning of the second wave. Depression-anxiety was defined as a cut-off of 20 or higher on the Patient Health Questionnaire-Anxiety Depression Scale (PHQ-ADS). Of 1138 participants, 71.0% were female, 69.0% Arabs, 70.0% Non-Qataris, and 77.0% were < 40 years (the median age in Qatar is 32 years). In a fully-adjusted model, six variables were significantly associated with moderate-to-severe levels of depression or anxiety on the PHQ-ADS; Arab ethnicity (OR = 1.67, p = 0.026), never married versus married (OR = 1.69, p = 0.015), prior history of psychiatric disorder versus no history (OR = 1.80, p = 0.009), increased worries due to social media use for COVID-related news/updates (OR = 1.72, p = 0.003), a history of COVID-19 (OR = 1.76, p = 0.039), loneliness (OR = 1.91, p < 0.001), and lower levels of religiosity (OR = 0.96, p = 0.039). These associations also pertained in the reduced model, with the exception of religiosity which was only marginally statistically significant (OR = 0.97, p = 0.055). The potential risk factors identified may assist with anxiety and depression prevention in future COVID-19 waves, and similar national events, and assist with early intervention to treat sufferers.

Perceived Consequences of Extended Social Isolation on Mental Well-Being: Narratives from Indonesian University Students during the COVID-19 Pandemic

Despite several recent studies reporting on young people's well-being during COVID-19, few large-scale qualitative studies have been carried out that capture the experiences of young people from low- and middle-income countries (LMICs) undergoing extended social restrictions. The challenges faced by young people from LMICs during COVID-19 are likely to be amplified by their countries' large populations, resource constraints, lack of access to health care, living conditions, socio-spatial contexts, and the pandemic's ramifications for communities. This study explored how youths perceived their well-being after being isolated for one-and-a-half years during the COVID-19 pandemic. Qualitative narrative research was employed as a method of inquiry. One-hundred and sixty-six university students in Jakarta, Indonesia, between the ages of 17 and 22 wrote reflective online essays on the consequences of extended pandemic isolation on their mental health. This data collection strategy offered an in-depth understanding of the phenomenon through the narratives of those who experienced it. Seven themes expressing the youths' perceived well-being were identified through inductive reflective thematic analysis: (1) the anguish of loneliness and estrangement; (2) a state of "brokenness" resulting from emotional agony and distress; (3) frustration, confusion, and anger; (4) the experience of conflicting emotions; (5) uncertainty about both the present and future; (6) a sense of purpose and fulfillment; and (7) turning to faith. The findings provide important insights into Indonesian youths' well-being following extended social restrictions following the outbreak. Their collective experiences can be used to inform policy and practice regarding the nature of support mechanisms required both during and following the pandemic, and in the future if such a situation were to occur again.

The Role of Clinical Activity, Loneliness, and Satisfaction with e-Health Services as Factors Affecting Quality of Life in Patients with Rheumatoid Arthritis During the SARS-CoV-2 Pandemic

INTRODUCTION

During the SARS-CoV-2 pandemic, most primary and specialist care outpatient clinics have started to offer their patients teleconsultation appointments as well as electronic prescriptions and referrals. For many patients, it was the only available way to access medical care.

PURPOSE

The aim of the study was to assess the quality of life in rheumatoid arthritis (RA) patients and determine whether loneliness and satisfaction with telemedicine service can affect their perceived QoL during the SARS-CoV-2 pandemic.

MATERIAL AND METHODS

One hundred and forty-three RA patients (mean age 45.83±13.5 years) were included in the study. The De Jong-Gierveld Loneliness Scale (DJGLS), The Ankylosing Spondylitis Quality of Life Questionnaire (ASQoL) and the questionnaire of satisfaction with teleconsultations were used in the study. The following statistical tests were used in the study: Spearman correlation test, multivariate linear regression. A significance level of 0.05 was used in the analysis.

RESULTS

The patients presented a moderate level of loneliness (DJGLS; 31.1 points). The mean ASQoL score was 11.49±4.64. The correlation analysis showed a significant positive relationship between the level of loneliness and QoL - the higher the level of loneliness, the poorer the QoL (rho=0.283; p=0.001). An analysis of the relationship between satisfaction with teleconsultations and perceived QoL showed a statistically significant negative relationship - the higher the level of satisfaction with teleconsultations, the better the QoL (b=-0.166; p=0.047). The linear multivariate regression analysis showed that the loneliness (rho=0.1; p=0.01) was significant (p<0.05) independent predictor of QoL.

CONCLUSION

During the SARS-CoV-2 pandemic, RA patients experienced loneliness and their QoL was low. Teleconsultation visits proved to be unsatisfactory and negatively perceived by patients. Higher severity of RA symptoms (weakness, fatigue), being unemployed and loneliness during the blockade are independent determinants of reduced QoL in RA patients.

Stress-Buffering Role of Social Support during COVID-19

In order to reduce the high infection rate of COVID-19, individuals began to engage in self-isolation amid a time of uncertainty and worry. Given that social support can be protective against the negative effects of distress on mental and physical health, the lack of support may negatively impact individuals during their self-isolation. Thus, the current study examined the role of self-isolation on feelings of stress, the perception and reception of social support, and mental health problems during the COVID-19 pandemic. A sample of 405 college students were asked to report on the amount of self-isolation in which they were engaging, worry about COVID-19, psychological health, and received and perceived social support. Results indicated that when the length of time in self-isolation was taken into account, perceived social support buffered the connection between worry about COVID-19 and psychological health. These results indicate that social support, worry about COVID-19, and self-isolation may influence individuals' psychological health during times of stress.

The Well-being of children in lock-down: Physical, emotional, social and academic impact

The Covid-19 pandemic is having an unprecedented impact on societies. In the interest of maintaining social distancing, schools in many countries have closed their doors and children have been confined to their homes. Thus, the objective of the present study was to holistically analyze the well-being of children during a period of full lockdown in Spain, by considering physical, emotional, social, and academic indicators. The scale "Well-being of Children in Lockdown" (WCL) was used to measure the well-being of 1225 children from 2 to 12 years old from Northern Spain. The survey was completed by the parents and was designed to analyze children's well-being in terms of physical, emotional, social and academic aspects. The results suggest that the general well-being of children during lockdown was at an intermediate level. Analysis of the various measures of well-being revealed that the lowest levels were obtained for physical activity, along with creative and playful activities. Girls, younger children, and those who have access to an outdoor space showed the greatest levels of well-being. Finally, we discuss the implications of these findings for the well-being of children and, in particular, how this can be improved amid the current Covid-19 crisis.

Older Chinese migrants in coronavirus pandemic: exploring risk and protective factors to increased loneliness

Older migrants may be one of the most vulnerable populations during the coronavirus pandemic, yet the degree of impact remains largely unknown. This study explores (1) the consequences of the coronavirus pandemic for older Chinese migrants in Belgium and the Netherlands in terms of increased loneliness and its risk factors (reduced in-person contact, decreased social participation, feelings of existential threat) and protective factors (increased non-in-person contact, more individual activities), and (2) which risk and protective factors have contributed to the incidence and prevention of higher loneliness levels. Using quantitative data of a survey among 98 Chinese migrants aged 50 years and older in Belgium (n = 84) and the Netherlands (n = 14), the findings first indicate that the coronavirus pandemic has a significant impact on older Chinese migrants' lives. One in five experienced more loneliness. Second, reduced social participation (measured as less frequent participation in outdoor group activities) and financial insecurity (measured as experiencing financial difficulties) lead to higher than pre-pandemic loneliness levels. Problem-focused coping strategies (measured as increased non-in-person contact, via telephone or social media) and emotion-focused coping (measured as finding distraction through increased participation in individual activities) were not found to protect against increased loneliness in the pandemic. Two practical implications for loneliness interventions for older Chinese migrants are put forward. Organizing COVID-19-safe social participation activities and paying more attention to older Chinese migrants' financial situation can be beneficial when addressing higher levels of loneliness due to the coronavirus pandemic.

Caring for a person with dementia during the COVID-19 pandemic: a qualitative study with family care-givers

The aim of this study was to explore the experience of family care-givers of people with dementia during the COVID-19 pandemic in the Veneto region of Italy to understand how and to what extent the emergency has affected care-givers’ lives and care routines. Twenty adult children of an ill person were interviewed via phone and video call, in adherence with the restrictions against COVID-19. Thematic analysis showed five main themes: the care-giver's experience, the care recipient's experience, relationships with care recipients, changes in the care routine and resources. Results pointed out that the time needed in the care routine and everyday activities increased during the pandemic, together with the need to find alternatives to physical activity at home. Depending on one's personal experience of COVID-19 and approach to preventive rules, the availability of resources, and formal and informal support, three main approaches to care were identified: apprehensive, mindful and fatalistic ones. The pandemic amplified the differences among these already-existing approaches to care as well as the typical challenges and difficulties experienced by family care-givers, and it resulted in an increased burden connected to practical difficulties, emotional stress and difficulties in reaching for help. These results underline the importance of strengthening the external support network for older people to help family care-givers, especially during emergencies.

Is Watching TV Series an Adaptive Coping Strategy During the COVID-19 Pandemic? Insights From an Italian Community Sample

Social distancing and lockdown due to the COVID-19 pandemic substantially impacted individuals' daily habits and well-being. Within such a context, digital technology may provide a welcome source of alternative forms of connection and entertainment. Indeed, streaming services showed a remarkable increase in membership subscriptions throughout the period considered. However, excessive involvement in watching TV series has recently become a subject of scholarly concern as it may represent an emerging form of addictive behavior with the features of what has been labeled as "binge-watching" (i.e., watching multiple episodes of TV series in a single session). The current study aimed to assess TV series watching behaviors and related motivations, as well as their relationships with depression, stress and anxiety, in a sample of Italian adults during the COVID-19 lockdown. Specifically, we aimed to explore which patterns of motivations and emotional states influenced either a high but healthy engagement in watching TV series, or promoted problematic and uncontrolled watching behavior under such circumstances. A total of 715 adults (M = 31.70, SD = 10.81; 71.5% female) from all over Italy were recruited (from 1st to 30th April 2020) through advertisements via social media platforms of Italian university communities and other online groups. Two multiple hierarchical regression analyses were performed with non-problematic and problematic TV series watching set as dependent variables. Results showed that people spent more time watching TV series during the pandemic lockdown, especially women who also reported higher levels of anxiety and stress than men. Moreover, both non-problematic (R 2 = 0.56; p < 0.001) and problematic (R 2 = 0.33; p < 0.001) TV series watching behaviors were equally induced by anxiety symptoms and escapism motivation, thereby suggesting that watching TV series during the COVID-19 lockdown probably served as a recovery strategy to face such a stressful situation. Finally, our findings also suggest that enrichment motives may protect from uncontrolled and potentially addictive watching behaviors. These findings, therefore, hold important implications, particularly for avoiding the over-pathologization of excessive involvement in online activities emerging as a result of specific distressing situations.

Social support, perceived risk and the likelihood of COVID-19 testing and vaccination: cross-sectional data from the United Kingdom

Two samples of 227 and 214 adults completed surveys of social support, perceived risk of COVID-19 and COVID-19 preventive activity - in Study 1 likelihood of testing was examined and in Study 2 likelihood of both testing and vaccination were examined during the COVID-19 pandemic in the United Kingdom. Path analysis showed, in Study 1, that access to help (as an indicator of social support) had a direct effect on likelihood of testing and indirect effects through self-efficacy, perceived risk and preventive behavior; and, in Study 2, that neighborhood identification (as an indicator of social support) had a direct effect on likelihood of testing and indirect effects on likelihood of both testing and vaccination through the mediators of strength of social network, loneliness, perceived risk of COVID-19, and preventive activity. Both studies suggest that level of social support (conceptualized in different ways) is an important determinant of COVID-19 testing and Study 2 shows it is also a determinant of likelihood of vaccination. As resurgences of COVID-19 occur, it will be necessary to monitor the likelihood of COVID-19 testing and vaccination behaviors and, especially, to promote confidence in the latter in individuals with decreased access to social support.

A chain mediation model on COVID-19 symptoms and mental health outcomes in Americans, Asians and Europeans

The novel Coronavirus-2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO) in March 2020, impacting the lifestyles, economy, physical and mental health of individuals globally. This study aimed to test the model triggered by physical symptoms resembling COVID-19 infection, in which the need for health information and perceived impact of the pandemic mediated the path sequentially, leading to adverse mental health outcomes. A cross-sectional research design with chain mediation model involving 4612 participants from participating 8 countries selected via a respondent-driven sampling strategy was used. Participants completed online questionnaires on physical symptoms, the need for health information, the Impact of Event Scale-Revised (IES-R) questionnaire and Depression, Anxiety and Stress Scale (DASS-21). The results showed that Poland and the Philippines were the two countries with the highest levels of anxiety, depression and stress; conversely, Vietnam had the lowest mean scores in these areas. Chain mediation model showed the need for health information, and the perceived impact of the pandemic were sequential mediators between physical symptoms resembling COVID-19 infection (predictor) and consequent mental health status (outcome). Excessive and contradictory health information might increase the perceived impact of the pandemic. Rapid COVID-19 testing should be implemented to minimize the psychological burden associated with physical symptoms, whilst public mental health interventions could target adverse mental outcomes associated with the pandemic.

Religious Support as a Contribution to Face the Effects of Social Isolation in Mental Health During the Pandemic of COVID-19

Coping with the COVID-19 pandemic has required measures to contain the contagion, including social isolation. However, this and other factors have caused mental health problems, both in patients and health professionals and in family members or asymptomatic population. Religious support can be an ally for this type of confrontation. In the case of the COVID-19 pandemic, spiritual/religious care has been restricted and insufficient. When accessible to patients and frontline professionals, they are offered by virtual means, almost always by recorded media and made available in bulk. This essay argues, based on references in the areas of psychology, psychoneuroimmunology, biosafety, and military, that the face-to-face and personalized relationship between religious leaders, patients, health professionals, family members, and faith communities is as essential as possible for the dignified treatment victims, referral to spiritual needs and resilience of society, in addition to contributing to the improvement of the immune response of all. Practical examples are cited in the areas of military chaplaincy and hospital civilian chaplaincy. The essay also proposes the adoption of protocols already published by WHO and other safety measures such as the use of robotics and the recruitment/training of mass chaplains. In addition to contributing to the improvement of COVID-19 pandemic coping processes, the study also contributes to improving the delivery of spiritual/religious care as an ally to physical and mental, individual, and collective health.

Longitudinal correlates of loneliness and psychological distress during the lockdown situation due to COVID-19. Effects of age and self-perceptions of aging

Objectives

To longitudinally analyze the correlates of loneliness and psychological distress in people exposed to the coronavirus disease 2019 (COVID-19) lockdown, exploring the effects of age and self-perceptions of aging (SPA).

Methods

A longitudinal follow-up of 1,549 participants was carried out at four different time points during the lockdown in Spain. Questions about the risk of COVID-19, age, SPA, family and personal resources, loneliness, and psychological distress were measured.

Results

Changes in loneliness showed a linear longitudinal trajectory through time, but changes in psychological distress showed a U-shaped relationship with time. Age was a relevant predictor of differences in distress, with older people reporting less psychological distress. Change in both dependent variables was related to change in different predictors like family and personal variables and also to negative SPA.

Discussion

In a stressful situation such as the COVID-19 pandemic, older adults may be more resilient to adverse mental health outcomes by using more adaptive resources that strengthen their resilience. Support is provided for the importance of stereotyped views of the aging process that, independently of chronological age, may put people at risk of suffering adverse mental health outcomes such as loneliness and psychological distress in times of crisis.

Emotional Well-Being Under Conditions of Lockdown: An Experience Sampling Study in Austria During the COVID-19 Pandemic

The coronavirus (COVID-19) pandemic and attendant lockdown measures present serious threats to emotional well-being worldwide. Here, we examined the extent to which being outdoors (vs. indoors), the experience of loneliness, and screen-time are associated with emotional well-being during the COVID-19 pandemic using an experiencing sampling method. In April 2020, Austrian adults (N = 286, age M = 31.0 years) completed a 21-day experience sampling phase in which they reported their emotional well-being (i.e., happiness), whether they were indoors or outdoors, and loneliness at three random time-points each day, as well as their daily screen-time. Results indicated that being outdoors was associated with higher emotional well-being, whereas greater loneliness and greater daily screen-time were associated with poorer well-being. Additionally, the impact of loneliness on well-being was weaker when participants were outdoors than indoors. These results have health policy implications for the promotion of population well-being during pandemics.

Facing Loneliness and Anxiety During the COVID-19 Isolation: The Role of Excessive Social Media Use in a Sample of Italian Adults

The outbreak of coronavirus disease 2019 (COVID-19) prompted people to face a distressing and unexpected situation. Uncertainty and social distancing changed people's behaviors, impacting on their feelings, daily habits, and social relationships, which are core elements in human well-being. In particular, restrictions due to the quarantine increased feelings of loneliness and anxiety. Within this context, the use of digital technologies has been recommended to relieve stress and anxiety and to decrease loneliness, even though the overall effects of social media consumption during pandemics still need to be carefully addressed. In this regard, social media use evidence risk and opportunities. In fact, according to a compensatory model of Internet-related activities, the online environment may be used to alleviate negative feelings caused by distressing life circumstances, despite potentially leading to negative outcomes. The present study examined whether individuals who were experiencing high levels of loneliness during the forced isolation for COVID-19 pandemic were more prone to feel anxious, and whether their sense of loneliness prompted excessive social media use. Moreover, the potentially mediating effect of excessive social media use in the relationship between perceived loneliness and anxiety was tested. A sample of 715 adults (71.5% women) aged between 18 and 72 years old took part in an online survey during the period of lockdown in Italy. The survey included self-report measures to assess perceived sense of loneliness, excessive use of social media, and anxiety. Participants reported that they spent more hours/day on social media during the pandemic than before the pandemic. We found evidence that perceived feelings of loneliness predicted both excessive social media use and anxiety, with excessive social media use also increasing anxiety levels. These findings suggest that isolation probably reinforced the individuals' sense of loneliness, strengthening the need to be part of virtual communities. However, the facilitated and prolonged access to social media during the COVID-19 pandemic risked to further increase anxiety, generating a vicious cycle that in some cases may require clinical attention.

Mental Well-Being During Pandemic: The Role of Cognitive Biases and Emotion Regulation Strategies in Risk Perception and Affective Response to COVID-19

Both cognitive appraisals of risks associated with the specific disease and affective response to crisis situations have been shown to shape an individual response to pandemics. COVID-19 pandemic and measures introduced to contain it present an unparalleled challenge to mental well-being worldwide. Here, we examine the relationship between self-reported cognitive biases (CB) and emotion regulation skills (ER), COVID-19 risk perception and affective response, and mental well-being (MWB). Five Hundred and Eleven individuals completed General Health Questionnaire, Emotion Regulation Questionnaire, Davos Assessment of Cognitive Biases Scale (DACOBS) as well as scales measuring COVID-19 risk perception and affective response during the initial days of the epidemic in Poland. We used path and bootstrapping analyses to examine the hypothesis that CB may shape MWB during COVID-19 pandemic both directly and indirectly by (i) decreasing ER capacity and (ii) by increasing COVID-19 risk perception and affective response. Negative effect of CB and positive effect of ER via cognitive reappraisal on MWB were observed in participants. Furthermore, in line with our hypothesis, we observed indirect effects of CB via increased COVID-19 risk perception and affective response and decreased use of reappraisal strategy, which all, in turn, were related to MWB. Finally, we found an indirect effect of CB on MWB through double mediation of suppression strategies and COVID-19 affective response. Results of the current study suggest that CB, which have been shown to be linked to a variety of mental health symptoms in non-clinical populations, may exacerbate the impact of the COVID-19 pandemic on mental health outcomes.

The COVID-19 Pandemic: A Pandemic of Lockdown Loneliness and the Role of Digital Technology

The focus of this perspective is on lockdown loneliness, which we define as loneliness resulting from social disconnection as a result of enforced social distancing and lockdowns during the COVID-19 pandemic. We also explore the role of digital technology in tackling lockdown loneliness amid the pandemic. In this regard, we highlight and discuss a number of the key relevant issues: a description of lockdown loneliness, the burden of lockdown loneliness during the COVID-19 pandemic, characteristics of people who are more likely to be affected by lockdown loneliness, factors that could increase the risk of loneliness, lockdown loneliness as an important public health issue, tackling loneliness during the pandemic, digital technology tools for social connection and networking during the pandemic, assessment of digital technology tools from the end users' perspectives, and access to and use of digital technology for tackling lockdown loneliness during the COVID-19 pandemic. We suggest that the most disadvantaged and vulnerable people who are more prone to lockdown loneliness are provided with access to digital technology so that they can connect socially with their loved ones and others; this could reduce loneliness resulting from social distancing and lockdowns during the COVID-19 crisis. Nonetheless, some key issues such as access to and knowledge of digital technology tools must be considered. In addition, the involvement of all key stakeholders (family and friends, social care providers, and clinicians and health allied professionals) should be ensured.

Loneliness during a strict lockdown: Trajectories and predictors during the COVID-19 pandemic in 38,217 United Kingdom adults

RATIONALE

There are increasing worries that lockdowns and 'stay-at-home' orders due to the COVID-19 pandemic could lead to a rise in loneliness, which is recognised as a major public health concern. But profiles of loneliness during the pandemic and risk factors remain unclear.

OBJECTIVE

The current study aimed to examine if and how loneliness levels changed during the strict lockdown and to explore the clustering of loneliness growth trajectories.

METHODS

Data from 38,217 UK adults in the UCL COVID -19 Social Study (a panel study collecting data weekly during the pandemic) were analysed during the strict lockdown period in the UK (23/03/2020-10/05/2020). The sample was well-stratified and weighted to population proportions of gender, age, ethnicity, education and geographical location. Growth mixture modelling was used to identify the latent classes of loneliness growth trajectories and their predictors.

RESULTS

Analyses revealed four classes, with the baseline loneliness level ranging from low to high. In the first a few weeks of lockdown, loneliness levels increased in the highest loneliness group, decreased in the lowest loneliness group, and stayed relatively constant in the middle two groups. Younger adults (OR = 2.17-6.81), women (OR = 1.59), people with low income (OR = 1.3), the economically inactive (OR = 1.3-2.04) and people with mental health conditions (OR = 5.32) were more likely to be in highest loneliness class relative to the lowest. Further, living with others or in a rural area, and having more close friends or greater social support were protective.

CONCLUSIONS

Perceived levels of loneliness under strict lockdown measures due to COVID-19 were relatively stable in the UK, but for many people these levels were high with no signs of improvement. Results suggest that more efforts are needed to address loneliness.

Buffering Academic Stress during the COVID-19 Pandemic Related Social Isolation: Grit and Growth Mindset as Protective Factors against the Impact of Loneliness

The pandemic of the SARS CoV-2 virus, which causes COVID-19 sickness, constitutes a global challenge to well-being. Positive psychology constructs of grit and growth mindset may offer a solution to this challenge as both are associated with psychological resilience. A growth mindset describes the underlying beliefs people have about the malleability of intelligence, and grit refers to dedication to long-term goals. The present study explored whether such constructs could constitute protective factors against the academic stress associated with loneliness and perceived lack of control among international students (n = 170) during social isolation, induced by COVID-19 restrictions. The results of a hierarchical multiple regression model explained 36% of the variance in academic stress with a perceived lack of control (ß = .53, p < .001) and growth mindset (ß = -.22, p < .001) being significant direct predictors. Moderation analysis explained 17% of the variance and confirmed that a level of dispositional grit moderated the detrimental influence loneliness had on academic stress. Simple slopes analysis revealed a significant effect for moderate (β = .07, p = .01) and high (β = .16, p = .001) levels of grit. Our findings suggest that grit and growth mindset, as dynamic variables, could be taught to students as resilience-building prevention of academic stress during the COVID-19 pandemic. Lastly, our results have shown that parents (37%) and friends (32%) were most frequently identified by students as supporters during the COVID-19 pandemic with minimal reported support from universities (2.5%).

Design and Validation of a Scale for Measuring Well-Being of Children in Lockdown (WCL)

The objective of this study was to create and validate an instrument to measure the well-being of children in lockdown. As a response to the COVID-19 pandemic, and in the interest of maintaining social distancing, millions of people have been confined to their homes, including children, who have been withdrawn from school and barely able to leave their homes. Thus, it would be useful to evaluate, from a holistic perspective, the well-being of children under these challenging circumstances. The participants were 1,046 children, 48.7% of which were boys and 50.7% girls, recruited in the Basque Country (Northern Spain). The scale was answered by their parents. The survey, entitled "Well-being of Children in Lockdown" (WCL), is composed of six subscales: Emotions, Playful and creative activities, Education, Addictions, Routine, and Physical Activity. Exploratory factor analyses indicate that all the reliability indices were acceptable. The survey demonstrated adequate reliability (alpha = 0.804). We were thus able to confirm the validity of this simple instrument for evaluating the well-being of children aged between 4 and 12 years in lockdown situations. The WCL can be regarded as a useful tool to evaluate the well-being of children in lockdown situations.

Who is lonely in lockdown? Cross-cohort analyses of predictors of loneliness before and during the COVID-19 pandemic

BACKGROUND

There are concerns internationally that lockdown measures taken during the coronavirus disease 2019 (COVID-19) pandemic could lead to a rise in loneliness. As loneliness is recognised as a major public health concern, it is therefore vital that research considers the impact of the current COVID-19 pandemic on loneliness to provide necessary support. But it remains unclear, who is lonely in lockdown?

METHODS

This study compared sociodemographic predictors of loneliness before and during the COVID-19 pandemic using cross-cohort analyses of data from UK adults captured before the pandemic (UK Household Longitudinal Study, n = 31,064) and during the pandemic (UCL (University College London) COVID-19 Social Study, n = 60,341).

RESULTS

Risk factors for loneliness were near identical before and during the pandemic. Young adults, women, people with lower education or income, the economically inactive, people living alone and urban residents had a higher risk of being lonely. Some people who were already at risk of being lonely (e.g. young adults aged 18-30 years, people with low household income and adults living alone) experienced a heightened risk during the COVID-19 pandemic compared with people living before COVID-19 emerged. Furthermore, being a student emerged as a higher risk factor during lockdown than usual.

CONCLUSIONS

Findings suggest that interventions to reduce or prevent loneliness during COVID-19 should be targeted at those sociodemographic groups already identified as high risk in previous research. These groups are likely not just to experience loneliness during the pandemic but potentially to have an even higher risk than normal of experiencing loneliness relative to low-risk groups.

Struggling to breathe: a qualitative study of children's wellbeing during lockdown in Spain

OBJECTIVE

COVID-19 has spread throughout the world, including Europe. In order to halt the spread of the pandemic by maintaining social distancing, all children in Spain have been completely confined to their homes, and from March 13th to April 26th they were forbidden from going outdoors at any time. The aim of this research was gather the voices of children in lockdown during the COVID-19 pandemic in Spain in order to examine how they are coping with this health crisis. Design: A sample of 250 Children from a region of Spain aged 3-12 years (mean 7.14) were openly asked about their lockdown activities, needs, and feelings. Main Outcome Measures: Responses were analyzed using Iramuteq software for lexical analysis. Results: Children reported having mixed emotions in lockdown; whilst they are happy and relaxed with their families, they also feel fear, nervousness, worry, loneliness, sadness, boredom, and anger. At a physical level, Children noted it was difficult to be deprived of fresh air for weeks, which also makes them primarily sedentary, and they missed outdoor exercise. Socially, they missed peers and caregivers. Conclusion: This study provides evidence about the need to safeguard children's wellbeing during the COVID-19 crisis.

Ten considerations for effectively managing the COVID-19 transition

Governments around the world have implemented measures to manage the transmission of coronavirus disease 2019 (COVID-19). While the majority of these measures are proving effective, they have a high social and economic cost, and response strategies are being adjusted. The World Health Organization (WHO) recommends that communities should have a voice, be informed and engaged, and participate in this transition phase. We propose ten considerations to support this principle: (1) implement a phased approach to a 'new normal'; (2) balance individual rights with the social good; (3) prioritise people at highest risk of negative consequences; (4) provide special support for healthcare workers and care staff; (5) build, strengthen and maintain trust; (6) enlist existing social norms and foster healthy new norms; (7) increase resilience and self-efficacy; (8) use clear and positive language; (9) anticipate and manage misinformation; and (10) engage with media outlets. The transition phase should also be informed by real-time data according to which governmental responses should be updated.