Impact of social isolation due to COVID-19 on vulnerable geriatric population: a study of physical and psychological wellbeing

Purpose: The purpose of this study is to gain a deeper understanding of the impact of social isolation due to COVID-19 on the vulnerable geriatric population. Design/methodology/approach: Ten individual interviews of people above 70 years of age were conducted in 2021. The data was collected through interviews and observation. The authors observed the people from the age. Findings: The geriatric population faced physical challenges like poor sleep and digestive health along with neglect of their persisting ailments, which needed attention. Mental issues were also very serious, such as fear of death, anxiety, stress and depression. This paper urges the policymakers to focus on coming up with support systems for the geriatric population and finding long-term solutions to mitigate the repercussions faced by them. Originality/value: This paper attempts to underline the mostly unnoticed physical and psychological issues troubling usually neglected strata of the population as they do not make a part of an income-earning segment. © 2022, Emerald Publishing Limited.

Social Isolation in a Crisis in Hartmann Von Aue's Iwein

This article investigates the social isolation of the protagonist in a crisis using the example of Iwein by Hartmann von Aue. It is an Arthurian novel written around 1203 which depicts the adventures of the knight Iwein of the Round Table. The novel embodies various medieval topics such as the struggle for honour, loyalty, knight's duties and virtues, challenges, mythical and fantastic beasts, etc. Among these subjects, there is also the so-called crisis of a hero, which is represented by social isolation and mental illness, i. e. by the knight's insane behaviour. Thus, the depiction of Iwein's isolation will be interpreted, analysed and critically evaluated in relation to his illness and recovery in the context of the crisis. In addition, the function and the representation of this isolation in regard to the knighthood and court society of the time will also be examined. Therefore, this article attempts to answer the following questions: How is Iwein's social isolation depicted during his crisis and what role does this isolation play during the crisis in terms of his illness and recovery? What is the difference between isolation, loneliness and marginalisation in this novel? The crisis will be examined in the context of literature and literary studies and at the same time with reference to the social isolation. Using the example of this Arthurian novel, the crisis of the protagonist before and during the period of isolation will be analysed and interpreted with regard to overcoming challenges (physical and psychological), loneliness, despair and even madness. The previous research of this Arthurian romance focused mainly on topics such as the question of Iwein's guilt or madness. Especially, it is Iwein's phase of madness during his isolation that most of these works investigate, either in the context of illnesses as shown by Christine Saygin (35-60) or, for example, in relation to the adventures and the function of madness in Chretien's and Hartmann's version of this story as shown by Wolfgang Mohr (71). Saygin (59), for example, assumes that Iwein's insanity was created by the author to characterize Iwein's illness and is considered to be an "alternative to suicide". Saygin (59) also explains that madness "... perhaps also offers the knight the possibility of ultimately redeeming himself [...]".6In this paper, however, it is assumed that Iwein's isolation plays a crucial role in Iwein's illness and recovery and that his madness can only be interpreted as a symptom of this isolation. In this way, his insane episode is observed in relation to his isolation and not separately. The beginning of Iwein's state of madness matches approximately the beginning of his isolation -after his wife Laudine realized that he had not kept his end of their agreement, therefore their honour was violated. So Laudine makes the decision to part with Iwein forever, in order to avoid any more shame. At this point in the plot, Iwein's isolation phase begins, as described in the following verses: ,,nach einem dinge jamert in, / daz er w ae re etewa / daz man noch wip enweste wa / und niemer gehorte mare / war er komen ware." (Hartmann, V. 3216-3220)The phenomenon of isolation is often associated with the feeling of loneliness. Walter Haug (1), who deals with the subject of loneliness of the epic hero in works such as Parzival by Wolfram von Eschenbach, "Gregorius" by Hartmann von Aue or Tristan by Gottfried von Stra ss burg, offers his own definition of loneliness. According to Haug (1), it would be better to avoid the term loneliness and instead use another term meaning "belonging to a society"7. Besides loneliness, one must also offer here a definition of the term isolation. Albrecht Classen (14) defines isolation using the example of Heinrich, Hartmann von Aue's Arthurian novel of the same name, as the withdrawal from society because of [Heinrich's] preparation for the coming death. In this paper, the absence of "being included in a society" 8 as defined by Haug (1) is considered as social isolation, and the aforementioned loneliness as yet another symptom of social isolation. Classen (14) also explains that Heinrich's (mental and physical) state does not change during his isolation, because it is closely linked to his illness and since the latter seems to be incurable, the isolation does not help him to overcome the crisis.The obvious difference between Heinrich and Iwein lies in the fact that Heinrich suffers from a physical and disgusting illness, while Iwein suffers from a mental disorder. Moreover, Iwein's illness reveals itself only during his isolation, which is not the case with Heinrich. For both protagonists, however, the isolation symbolises an exit from a shameful situation, i. e. they choose isolation because they were experiencing a crisis and can no longer bear the shame of the lost honour.Iwein's isolation from the society also symbolises his return to his innate nature. He gives in to primordial urges that forces him to seek safety and comfort in isolation. As a matter of fact, these are somewhat animalistic and wild needs that force him to act uncontrollably, as seen in the scene where he rips off his clothes and exposes himself. In a symbolic manner, he thus gets rid of the shackles of the court and the Round Table, as well as the negative feelings and the shame, and only then does his phase of madness truly begin. It can also be noted that up to this point in the plot, Iwein's thoughts and those of the other characters have been described and commented by the narrator on several occasions. However, in Iwein's state of insanity his thoughts are completely suppressed. The reader (or the listener) no longer gets glimpses into the hero's thoughts as they are restricted by strong, primal urges such as hunger or thirst. In fact, it could be said that, the knight acts as if he was stunned and his thoughts and mind were frozen in a coma-like state: ,,als in der hunger bestuont, / so teter sam die toren tuont: / in ist niht mere witze kunt / niuwan diu a umbe den munt. "(Hartmann, V. 3266-3270)Since the medieval perception of diseases, epidemics and mental disorders was strongly influenced by people's superstitions and beliefs, it is not surprising that Iwein's illness and healing cannot be traced gradually. He suddenly became insane, that is, sick and in the same way will he later suddenly be cured, by magic and without further explanation.Hence, his illness represents nothing more than a crisis, or a heroic crisis to be exact, that Iwein has to overcome. According to Vollmann (237), "the classic Arthurian hero is a crisis-prone and that is his strength."9 Moreover it can be observed that Hartmann von Aue introduces the hero's crisis into the story in an already familiar manner which corresponds to the so-called double path structure, because the crisis represents the turning point of the plot according to this structural model. Similar to his work Poor Heinrich, the knight falls into a crisis that is triggered by various factors that vary from illness (Heinrich), violation of honour (Iwein) to committing a serious sin (Gregorius). Aside from how the hero's crisis is triggered, it offers the protagonist his salvation by empowering him, so that he is able to overcome in future more difficult challenges. However, the reason for the occurrence of a heroic crisis is common to all these knights - when a large discrepancy between the knight's moral values or philosophies of life and the expectations and norms of the society emerges, a crisis occurs. Since this discrepancy requires a change in order to be reconciled, the knight can no longer remain in the society whose norms and traditions he does not conform to anymore, and this will often result in knight's isolation. In this case, Iwein isolates himself from the court and the Round Table, which he can no longer be a part of. In developing the heroic crisis, Hartmann uses a role model that is considered as the starting point of all ideas about a knight in a knightly society - at the court of King Arthur, it is Arthur himself who serves as a role model for all knights.If the members of a knightly society do not conform to the knightly role model, they may also be marginalized. This is the case with Iwein, whose previously mentioned new, untamed and wild way of life is perceived as insane by the court society. Consequently, he becomes gradually marginalized from this society. However, his isolation need not be considered marginalization if one assumes that Iwein has deliberately distanced himself from society. Auffahrt (340) defines marginality as: "a sociological model for people who live on the margins of society, that is, who are excluded from the privileges of those who determine society (this is not necessarily the majority of a society). Accordingly, they have a different view of the living world and develop their own values."10 The difference between marginalization and marginality here lies in the fact that marginalization refers to the process and marginality refers to the result of that process. Crewe (121) adds on the topic of marginality in literature that this phenomenon necessarily juxtaposes notions of "center" and "margin" in the context of Jacques Derrida's deconstructionist theories. In relation to the Arthurian novel, it can be stated that the Arthurian court, together with King Arthur along with his knights, represents the center of courtly society and, according to Wolfzettel (4), even the center of the world (Wolfzettel 4). Furthermore, the marginality in the Arthurian novel can be defined as a concept of representing characters who are either in Arthur's court (at the center of society) or outside the court (at the margins of society). Regarding the aforementioned definition of Auffahrt (340) Iwein can be seen as an individual onthe margins of society who is considered different from the center of his society or from the Arthurian court by "his view of the living world".The reason for the marginalization lies above all in the question of how useful a person is for the society, or in this case for the court society and for the Round Table. Using Heinrich as an example, it can be seen that the protagonist himself recognized beforehand that he could no longer be of use to his society and for this reason he opts for isolation. With regard to Iwein, a situation is shown where the protagonist cannot bear that his society sees him as an unworthy member. Therefore, he isolates himself from others before they can exclude him from the society and marginalise him. This can be seen in the example of the forest man, who was mentioned at the very beginning of the story and whom first Kalogrenant and then later Iwein encounter, while searching for the magic fountain. From the perspective of the knights of the Round Table, the forest man is perceived as a mad and a strange beast, also marginalized by the chivalric society. Similarly, it is now Iwein who evokes such reactions from others when they meet him. In other words, he has shifted from the role of the knight of the Round Table to the role of a lunatic resembling the forest man. What he once perceived as wild and inhuman about the forest man will not only known but also inherent to him. In the same way, Iwein is now seen as a madman from the perspective of the knights of the Round Table and the court society, for whom he has lost the qualities that used to make him human. Even though his humanity is not determined by this society, it is judged by it, which is why he no longer conforms to the idea of humanity at the court of King Arthur.Hence, what was considered to be the madness of Iwein is actually the madness of the Arthurian court and the Round Table. The madness of an entire society that forces a knight to reinvent his very essence, so that he could once again conform to the norms and role models of this society. Regarding that society, Sacker (5-6) argues that King Arthur is portrayed as a passive and weak figure and the Knights of the Round Table as useless members of this society. Furthermore, Sacker (8) explains that the depiction of the knightly duel and the winning of the ere through the murder of the opponent are actually symptoms of a society in crisis that lives by a flawed code that no one questions. Thus, the events and the transformation of Iwein that occur during his crisis can be seen as an ironical depiction of Hartmann's critique of a flawed medieval society and the knightly codex.Even though, Iwein successfully overcame his crisis, it can be observed that, in what was probably Hartmann von Aue's last Arthurian novel, a novelty in overcoming the heroic crisis was introduced. This is precisely Iwein's isolation and its role in overcoming the crisis. When it comes to healing his sickness, the isolation is a novelty in the structuring of the heroic crisis in medieval literature. The heroes mentioned earlier always sought an exit from difficult or unbearable situations in isolation and this is also the case with Iwein, but unlike them, Iwein uses the isolation as a shield against societal expectations and judgments, which allows him to rediscover his true purpose and inner nature in the isolation amidst the chaos and the balance of nature.The Round Table and King Arthur recognize the knight Iwein as a loyal, honourable, and courageous knight, but only after he had overcome all the challenges that were set before him after his isolation. In this respect, the novel also portrays a socio-critical dimension, which primarily refers to social double standards and the loss of identity of the individual within a society. Because of this, the court's attitude to Iwein during his isolation can rather be described as a hindrance on his path to recovery, while the isolation, on the other hand, has the value of a remedy for Iwein. In the end, the crisis that Iwein experienced up to this point in the plot disappears and the aforementioned discrepancy between his expectations and those of the court society is reconciled. In fact, the function of the isolation was to provide Iwein with a safe area in which he could heal without being hindered by outside factors or influences. His numbness during this isolation served as a shield against feelings of loneliness, despair, or shame. Since there are no expectations, mistakes, shame or misdeeds in the wilderness, his isolation helps him reconnect with his inner nature and find balance in his life. Thus, the power of isolation does not lie in the loneliness, but in the reflection of the solitude, which allows the individuum to rebalance themselves, far from the disruptions of everyday life. After all, even today, because of the COVID-19 pandemic, things are out of balance. However, this pandemic has brought to light that even now, perhaps more than ever, one has the possibility to reconnect with oneself and with one's nature due to the isolation.

Alcohol Drinking in Adolescents Due to the COVID-19 Pandemic

Background: The COVID-19 pandemic caused changes in individuals' daily lives, including drinking habits. This study attempted to identify factors of Korean adolescents' current alcohol drinking due to the COVID-19 pandemic. Methods: The study used secondary data from the 17th Korean Youth Risk Behavior Web-based Survey that included 54 848 individuals. In this study, current alcohol drinking was defined as consuming at least 1 alcoholic drink per day for the past month. Changes in physical activity, mealtimes, smoking, and depressive symptoms were recorded. Results: The multiple logistic regression results show that the risk for current alcohol drinking due to the COVID-19 pandemic was 1.14 times higher in increased physical activity (95% CI: 1.04-1.25, P =.007);1.18 times higher in increased skipping breakfast (95% CI: 1.07-1.30, P =.001);1.22 times higher in decrease skipping breakfast (95% CI: 1.10-1.36, P <.001);and 15.69 times higher in increase smoking (95% CI: 12.53-19.64, P <.001). Conclusion: It is necessary to improve social support systems and related policies for adolescents who experienced a change in daily habits due to the COVID-19 pandemic. Our results may contribute to preparing strategies and support measures to reduce drinking by developing personalized healthcare in the future.

Which mediated social interactions satisfy the need to belong?

This investigation uses the two-process model of needs to explore differences between face-To-face communication and interpersonal media in terms of belongingness need satisfaction. Using experience sampling methods, Study 1 (N = 117) explored change in feelings of loneliness and connection from interpersonal media use within a day. Study 2 (N = 1,747) examined the association between loneliness and life satisfaction as mediated by patterns of interpersonal media use in the year following the COVID-19 outbreak. Study 3 (N = 303) experimentally manipulated social belonging to examine changes in interpersonal media use and resulting feelings of connection and disconnection. Overall, when individuals were more connected, their behaviors were more consistent with the two-process model, compared to when they felt disconnected. Additionally, although some interpersonal media use was better than no social contact at all, interpersonal media are not equally capable of satisfying belongingness needs. © 2022 The Author(s). Published by Oxford University Press on behalf of International Communication Association.

3. Adolescents' Perceptions of Mental Health around the World: Key Findings from a 13-Country Qualitative Study

Purpose: Adolescence (ages 10-19) is a sensitive developmental period for the emergence of mental and behavioral health problems, but there is a lack of multi-country qualitative studies that explore how adolescents themselves understand these critical challenges. As part of UNICEF's 2021 State of the World's Children Report, the Global Early Adolescent Study collaborated with organizations in 13 countries to hold a series of focus group discussions (FGDs) with adolescents focused on mental health. These FGDs aimed to (1) understand adolescents' perspectives on significant mental health challenges in their age group, (2) understand adolescents' perspectives on the key risk and protective factors driving these challenges, and (3) understand the ways in which adolescents cope with these challenges, including barriers and facilitators to help-seeking. Methods: A total of 71 FGDs were conducted across 13 countries between February and June of 2021. Countries were selected to ensure geographic, economic, and cultural diversity, and included: Belgium, Chile, China, the Democratic Republic of Congo, Egypt, Indonesia, Jamaica, Jordan, Kenya, Malawi, Sweden, Switzerland, and the United States. Within each country, FGDs were stratified by sex and age such that there were at least two younger (ages 10-14) and two older (ages 15-19) focus groups. Depending on the COVID-19 restrictions at the time, FGDs were either held in-person or online. All FGDs were held in local languages and lasted between 60 and 90 minutes. FGDs were recorded, transcribed verbatim, and translated into English when necessary. These English translations were then coded and analyzed using an inductive thematic analysis approach. Results: Across diverse cross-cultural settings, a number of consistent findings emerged from the voices of adolescents. In particular, adolescents around the world emphasized the many contexts that drive mental health challenges, including family adversity, community violence, unsupportive school environments, poverty, social media culture, and restrictive gender norms. They also discussed significant barriers to seeking help for mental health challenges, such as community stigma, lack of social support, and fears of invalidation. These barriers frequently resulted in adolescents coping with these challenges without support, often using maladaptive strategies. Importantly, adolescents generally described and understood mental health in terms of distress (e.g., sadness, loneliness, shame, anger) rather than disorder (e.g., depression, anxiety). Conclusions: Above all, it was clear that adolescents around the world need much better formal and informal supports to adequately address mental and behavioral health problems, and that these responses must take into account the many contexts that contribute to these problems. Further, the non-clinical terminology frequently used by adolescents suggests that taking a purely diagnostic approach in addressing mental health challenges may exclude many adolescents in need of assistance. Sources of Support: Wellcome Trust.

Effect of loneliness and sociodemographic, health, COVID-19 pandemic-related factors on depression among older adults

The present study aimed to identify the presence of depression in older adults and the affecting factors during the COVID-19 pandemic. This cross-sectional study was conducted online with 1320 deliberately recruited older adults in Turkey between February and May 2021. The variables were depression, loneliness, fear of COVID-19, and other sociodemographic health variables. In the study, we used the Geriatric Depression Scale, Loneliness Scale, and the Fear of COVID-19 Scale and RLa form including items inquiring information about sociodemographic and COVID-19 related characteristics and health conditions of the participants. In this study, we detected probable-definite depression in 73.8% of the participants. According to the results of multiple logistic regression analysis, we concluded that social and emotional loneliness, increased fear of COVID-19, perceived insufficient income, presence of chronic disease, managing activities of daily living only with assistance, irregular sleep and diet patterns, future anxiety, alcohol use, perception of mental health being negatively affected by the pandemic, and living in regions outside the Mediterranean Region affected the state of probable-definite depression in the participants. Depression was high in older adults during the pandemic. Psychosocial and health promotion interventions for depression risk factors determined from multivariate regression analysis, may enable older adults, who have become more vulnerable due to the restriction measures applied during the COVID-19 pandemic, to be less affected by this period.

47. Cultural Connection and Mental Health for American Indian Adolescents

Purpose: American Indian and Alaska Native (AI/AN) adolescents face significant physical and mental health disparities. These inequities result from historical and intergenerational traumas, which are the cumulative, permeating effects that impact individuals and communities who share a specific identity. Currently there is a paucity of research focusing on the mental health of AI/AN youth as well as the relationship between mental health and cultural connection. This project assesses the relationship between cultural identity (ethnic identity and tribal affiliation) and outcomes associated with mental health (loneliness, friendships, emotional support, and sleep) for AI/AN adolescents. It also aims to understand the impact of the COVID-19 pandemic on stress management for AI/AN adolescents. Methods: 12 to 18 year old adolescents from the Lumbee Tribe of North Carolina participated in this mixed-methods study. The project involved two phases informed by the principles of community-based participatory research. Phase 1, discussed in this , involved surveys using validated instruments to assess cultural connection, mental health outcomes, stress management, and resilience among participants. Phase 2 involves semi-structured interviews with adolescents. Results: Of 123 AI/AN youth who completed the survey, 54.5% (N=67) were 15-18 years old with mean age of 14.9 (SD=2.0). 61% (N=75) were assigned female at birth, 56% (N=70) identified as female, and 4.1% (N=5) identified as non-binary. Mean tribal affiliation (TA) and ethnic identity (EI) scores suggest strong cultural connection among participants (TA: mean 3.1/5, SD 0.6;EI: 3.4/5, SD 0.9). Sleep quality (mean 2.63/5) and positive stress management (mean 2.06/5) were low, suggesting room for improvement. Bivariate analysis and logistic regressions demonstrated moderate positive correlations between ethnic identity and friendship, ethnic identity and emotional support, tribal affiliation and friendship, and tribal affiliation and emotional support. Conclusions: Results highlight that AI/AN adolescents in this sample have a moderate-strong connection with culture, marked by ethnic identity and tribal affiliation. They also demonstrate the impact of cultural connection on mental health for AI/AN adolescents. Phase 2 will draw upon Phase 1 findings to further understand the relationship between cultural connection and mental health outcomes, and to promote community-driven interventions emphasizing inherent strengths and resiliencies identified through qualitative interviews of AI/AN youth. Data related to cultural connection and mental health outcomes may also be used to set the framework for policy formulation which may allow for increased funding and programming addressing mental health for AI/AN youth. Sources of Support: This research received support from the UNC Chapel Hill Office of Global Health.

The role of cognitive flexibility and hope in the relationship between loneliness and psychological adjustment: a moderated mediation model

Objectives: The COVID-19 pandemic caused people to suffer from secondary problems such as social isolation and loneliness as well as experiencing anxiety about catching and spreading the virus. Existing research emphasizes the roles of cognitive flexibility and hope for psychological adjustment but the mediating and moderating mechanisms have not yet been researched widely. Therefore, this study examined whether hope mediated the relationship between loneliness and psychological adjustment problems and whether cognitive flexibility moderated this mediation effect of hope in the relationship between loneliness and psychological adjustment problems during the COVID-19 pandemic curfew in Turkey. Methods: A total of 512 Turkish students and young adults completed UCLA Loneliness Scale, Brief Psychological Adjustment Scale, Dispositional Hope Scale, and Cognitive Flexibility Inventory for this cross-sectional study. Results: The results indicated that loneliness had a significant and positive predictive effect on the psychological adjustment problems and that this relationship was partially mediated by hope. Further, psychological flexibility moderated the relationship between loneliness and hope. Conclusions: The current study contributes a better understanding of the influence of loneliness on psychological adjustment, especially during the COVID-19 curfew period. KEY POINTS: What is already known about this topic: (1) Loneliness is positively associated with psychological adjustment problems. (2) Hope proved to play an important role in psychological adjustment during the COVID-19 pandemic. (3) Cognitive flexibility is positively related to hope. What this topic adds: (1) Hope mediates the relationship between loneliness and psychological adjustment problems during the COVID-19 curfew. (2) The association between loneliness and hope is moderated by cognitive flexibility, such that the association becomes weaker for those who report higher levels of cognitive flexibility. (3) The indirect effect of loneliness on psychological adjustment problems via hope is conditional on the levels of cognitive flexibility. © 2022 Australian Psychological Society.

Clinical psychologists' well-being and experiences of home working during COVID-19

Purpose: The purpose of this paper was to explore the well-being and experiences of working from home (WFH) for psychology staff across a range of specialties working within one health board in Scotland during the COVID-19 pandemic. Design/methodology/approach: In total, 161 clinical psychology professionals took part in an online survey that explored experiences of WFH during the COVID-19 pandemic and assessed well-being during this period. Findings: A number of challenges with WFH were identified, including challenges with carrying out clinical work (e.g. communication difficulties, risk assessment) and fewer opportunities for collaborative working and technical/equipment issues. During the WFH period, 46% experienced fatigue, 45% felt stressed and anxious and 30% felt lonely and isolated, compared to normal. Physical health complaints were also common with 37% experiencing aches/pains in back compared to normal and 40% experiencing headaches or migraines. Practical implications: Remote therapy should be directed to those with less complex needs or who require straightforward assessments. There should be increased access to occupational health assessments and provision of ergonomic furniture when WFH, and all staff should be supported to access well-being resources available within the health board. Further evaluation should be carried out to support evidence-based practice of remote clinical work. Originality/value: Few studies have explored the experiences of WFH and/or remotely from the perspectives of clinical psychologists in a Scottish health board. It is expected that this way of working will continue, albeit to a smaller extent;therefore, WFH policy will be informed by the findings.

Loneliness patterns and sleep problems after the initial outbreak of COVID-19: Findings from the Survey of Health, Aging and Retirement in Europe (SHARE)

The study addressed the relationship between loneliness and sleep deficits after the COVID-19 outbreak. We tested associations between patterns of loneliness before and after the outbreak [stable, improved, and worsened] and sleep quality outcomes: 1) having a sleep problem after the initial outbreak, and 2) change in sleep quality. Data were drawn from two data collection points in the Survey of Health, Aging and Retirement in Europe (Wave 8 and the SHARE-COVID telephone survey). The sample included 35,878 respondents from 27 countries who participated in both of the data collection points and had full information on the relevant variables. Having a sleep problem was measured on a single-item indicator. Five loneliness patterns were identified. These included three stable patterns: (1) 'little or no loneliness' (2) 'mild persistent loneliness,' (3) 'intense persistent loneliness,' and two patterns of change in loneliness status after the outbreak: (4) 'improved' and (5) 'worsened.' In the adjusted models, all of the loneliness patterns were associated with having a sleep problem after the initial outbreak, compared to those with a stable pattern of no loneliness. Moreover, intensive persistent loneliness almost doubled the risk of experiencing a sleep problem after the outbreak and was a robust predictor of a negative change in sleep quality. Among older adults, intense loneliness experienced both before and after the initial outbreak of COVID-19 emerged as the most deleterious loneliness status in terms of post-outbreak sleep quality.

Elder wellness during COVID-19: a student-directed intergenerational virtual discussion group

Objective: The COVID-19 pandemic saw increased loneliness and social isolation among older adults as activities and visitor opportunities for residential communities closed down. Health professional students have limited access to geriatric education in coursework and clinical experiences. The Recreation and Education Network for Elder Wellness (RENEW) programme was created by medical students at Baylor College of Medicine in Houston, Texas, aiming to increase engagement and cross-generational communication with older adults, while also decreasing social isolation and loneliness. Method: The RENEW programme included Zoom sessions with two Houston retirement communities led by student facilitators enrolled in medical, dental, and undergraduate programmes on a variety of topics of interest for the residents. Pre- and post-surveys were sent to participants and requested non-identifying biographical data and included the Revised UCLA Loneliness Scale. Results: Facilitators and participants expressed high satisfaction with the programme. Survey results on the Revised UCLA Loneliness Scale showed that participants had an overall decreased loneliness score after participation in RENEW. Student facilitators reported increased exposure to care of older adults and self-reported confidence in communicating with this population. Conclusions: The RENEW model is a collaborative, bidirectional educational tool for older adults and students with possible applications following the COVID-19 pandemic. © 2022 Australian Psychological Society.

Parental loneliness, parental stress and child mental health during the COVID-19 pandemic: Variations by cumulative socioeconomic risk.

Background: The COVID-19 pandemic has raised concerns about parent and child mental health, especially within disadvantaged families. However, little is known about how parental stress and loneliness during the pandemic influenced their children and no studies have investigated if these associations could vary by socioeconomic status. Methods: In July to September 2021, a large representative sample of parents (N = 4,524) in Québec (Canada) reported on aspects of their own mental health and that of their 9-10 year old child. Outcome variables were child externalizing and internalizing symptoms. Exposure variables were changes in parental loneliness and parental stress since the onset of the pandemic. The moderator variable was cumulative socioeconomic risk. Multiple linear regression analyses were executed and adjusted for confounding factors. Results: Child internalizing symptoms were associated with higher levels of parental stress (ß = 0.14, p<.001) and loneliness (ß = 0.23, p<.001). Child externalizing symptoms were also associated with parental stress (ß = 0.13, p<.001) and loneliness (ß = 0.18, p<.001). Most of these associations were stronger within the most disadvantaged households. Limitations: The cross-sectional design does not allow interpretations about causality. Conclusions: Increases in parental stress and loneliness since the onset of the COVID-19 pandemic would be detrimental to parent and child mental health. As these issues were amplified within families experiencing more socioeconomic adversities, our results can inform public policy to support families in times of crisis and direct resources to those most in need.

Evaluating Feasibility, Value and Characteristics of an Intergenerational Friendly Telephone Visit Program During the Covid-19 Pandemic.

OBJECTIVE: Volunteer organizations offer telephone outreach to older adults to relieve feelings of loneliness and to promote emotional well-being, though the feasibility, perceived value, and characteristics of the participant experience of these community interventions have not been well-studied. We examined these elements of an intergenerational college-based telephone call program during the Covid-19 pandemic. METHODS: Community-dwelling older adults and undergraduate volunteers engaged in eight, weekly, 30-minute, unscripted telephone conversations. Feasibility criteria included enrollment, retention, and attendance rates. A rapid qualitative analysis of program evaluation responses was used to extract themes related to participants' experiences of the intervention. RESULTS: Ten older adults (mean age [range] 74.53 [70-84] years, 88% women) and nine undergraduates were enrolled from February to August 2021, achieving recruitment targets and enrollment rates of 76.9% and 90%. Seven out of the 10 enrolled dyads completed the full series of eight telephone conversations and qualitative assessments over an average of 10.5 weeks. Most older adults who completed the call schedule valued the conversations as a source of social connection, noting the mutuality, respect, and broadened perspective that characterized their intergenerational relationships. Undergraduates described value in giving to others and in conversations that stimulated personal reflection and feelings of closeness. Undergraduates frequently described their experience as novel and broadening of their perspectives. CONCLUSION: Though study completion rate and participant experience varied across dyads, we found qualitative evidence of perceived value, active relationship-building and broadened perspectives among many older adults and undergraduates who completed an intergenerational telephone program.

How Can Music Engagement Address Loneliness? A Qualitative Study and Thematic Framework in the Context of Australia's COVID-19 Pandemic Lockdowns.

Social isolation and loneliness are serious public health concerns. Music engagement can strengthen social connections and reduce loneliness in some contexts, although how this occurs is not well understood; research suggests that music's capacity to manipulate perceptions of time and space is relevant. This study adopted a qualitative perspective to examine how music engagement shaped the experiences of residents of Victoria, Australia, during conditions of restricted social contact during the lockdowns of 2020. Semi-structured interviews explored participants' lived musical experiences while giving focus to perceptions of time and space (e.g., how music helped restructure home and workspaces in response to lockdown regulations, or punctuate time where older routines were no longer viable). Interpretative Phenomenological Analysis of the interview transcripts identified five themes representing the key findings: (1) a super-ordinate theme of perceived control, which comprises four themes: (2) dynamic connection; (3) identity; (4) mobility; (5) presence. Each theme describes one generalised aspect of the way music engagement shaped participants' perceptions of time and space during lockdown and supported their processes of adaptation to and coping with increased social isolation. The authors argue that these findings may inform the way music can be used to address loneliness in everyday life.

Loneliness in University Students during Two Transitions: A Mixed Methods Approach Including Biographical Mapping.

Several studies have shown that loneliness is prevalent in university students. However, up to now, it is less clear how transitions during this life stage are associated with loneliness. Therefore, we aimed to explore the association of loneliness with the transition from high school to university and the transition into the COVID-19 pandemic. Twenty students were interviewed in qualitative interviews based on a semi-structured guide that also included biographical mapping. In addition, the participants reported social and emotional loneliness based on the six-item De Jong Gierveld Loneliness Scale for three points in time: (1) at the time of the interview, (2) at the beginning of their studies at the university and (3) at the start of the COVID-19 pandemic. The qualitative data were analyzed using a structuring content analysis following Mayring. The quantitative data were analyzed using descriptive statistics. We found that emotional loneliness increased both during high school graduation and at the start of study at the university, as well as at the beginning of the COVID-19 pandemic. Social loneliness was higher during university studies than during the last years at high school and increased at the beginning of the pandemic. The results indicate that both transitions played an important role for perceived social and emotional loneliness. Further quantitative studies in larger samples will be relevant in the future to better target the responses to loneliness during transitions. Universities can actively counteract loneliness, especially during the transition from high school to university, by organizing events and meeting places where new students can network.

The Buffering Role of Self-compassion in the Association Between Loneliness with Depressive Symptoms: A Cross-Sectional Survey Study Among Older Adults Living in Residential Care Homes During COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic is an ongoing geriatric health emergency with a substantial increase in the prevalence of medical and mental health issues, particularly among older adults living in residential care homes. The knowledge of the risk and protective factors related to the psychological impact of the COVID-19 pandemic on older adults living in residential care homes is based on limited data. This study aimed to investigate whether loneliness mediates the effects of fear generated by a pandemic on depression. Additionally, we hypothesized that self-compassion moderates the effect of loneliness on depression. A sample comprised 323 older adults (females: n = 141, males: n = 182) with mean age = 74.98 years (standard deviation = 6.59, age 65-90) completed a survey comprising the Fear of COVID-19 Scale, De Jung Gierveld Loneliness Scale, the nine-item Patient Health Questionnaire, and the Self-compassion Scale. The results revealed that the total effect of fear on depression was statistically significant, with a medium effect size (Cohen's f 2 = .14) and this association was partially mediated by loneliness (ß = .11, SE = .04, P < .001, t = 2.91, 95% CI 0.04-0.19). The self-compassion also moderated the loneliness effect on depression. The findings of this study support COVID-19 evidence, indicating that a greater level of fear generated by the pandemic is linked to depression and loneliness. The findings support the notion that self-compassion mitigates the adverse effects of stressful events in older adults. Customized self-compassion programs may be effective loneliness-mitigating interventions for older adults living in residential care homes. Supplementary Information: The online version contains supplementary material available at 10.1007/s11469-023-01014-0.

What factors explain the changes in major depressive disorder symptoms by age group during the COVID-19 pandemic? A longitudinal study.

BACKGROUND: Data collected during the COVID-19 pandemic suggest an increase in major depressive disorder (MDD) among younger adults. The current study aims to assess the association of age groups and MDD risk before and during the COVID-19 pandemic and quantify the effect of potential mediating variables such as loneliness, social support, resilience, and socioeconomic factors. METHODS: A representative sample of Spanish adults was interviewed before (2019, N = 1880) and during (2020, N = 1103) the COVID-19 pandemic. MDD was assessed using the CIDI, loneliness through the UCLA scale, social support through the OSSS-3, resilience with the 6-BRS, and worsened economic circumstances and unemployment through a single question. Mixed-models were used to study changes in MDD by age group. Regression models were constructed to quantify the association between age and potential mediators, as well as their mediating effect on the association between age group and MDD. RESULTS: Among the younger age cohorts (18-29 and 30-44 years) the probability of having MDD during the pandemic increased from 0.04 (95 % CI: 0.002-0.09) to 0.25 (0.12-0.39) and from 0.02 (-0.001-0.03) to 0.11 (0.04-0.17), respectively. Some 36.6 % of the association between age and risk of MDD during the pandemic was explained by loneliness (12.0 %), low resilience (10.7 %), and worsened economic situation (13.9 %). LIMITATIONS: Reliance on self-report data and generalizability of the findings limited to the Spanish population. CONCLUSIONS: Strategies to decrease the impact of a pandemic on depressive symptoms among young adults should address loneliness, provide tools to improve resilience, and enjoy improved financial support.

Trajectories of loneliness during COVID-19 pandemic and associations with mental health and substance use.

We examined patterns of longitudinal trajectories of loneliness during the COVID-19 pandemic using six time points (January 2020 [pre-pandemic] to March/April 2021) and whether trajectories were associated with psychological distress (depression/anxiety) and substance use (alcohol/cannabis) outcomes in Spring 2021. Participants were 644 young adults who completed online assessments. Outcomes were regressed on most-likely loneliness trajectory adjusting for pre-pandemic measures. Three loneliness trajectories varied from consistently lower to consistently higher. Pre-pandemic social support was associated with lower odds of a higher loneliness trajectory. Higher loneliness trajectories were associated with greater odds of past-month cannabis use compared to Low trajectories, but not significantly associated with depression, anxiety, or alcohol use in Spring 2021. Interventions addressing co-occurring loneliness and cannabis use are needed.

Time-varying associations between loneliness and physical activity: Evidence from repeated daily life assessments in an adult lifespan sample.

Physical activity is a behavior that promotes physical and mental health; yet physical activity has decreased during the COVID-19 pandemic. To promote health during times of challenge, it is important to identify potential barriers to this key health behavior, such as loneliness. This brief report extends previous research on physical activity and loneliness that mainly focused on between-person differences to examine their time-varying associations at the within-person level using repeated daily life assessments. From April 2020 to August 2020, data were collected from a sample of 139 community-dwelling Canadian adults (M age = 40.65 years, SD = 18.37; range = 18-83 years). Each evening for 10 consecutive days, participants reported their loneliness, number of steps, and minutes of moderate-to-vigorous physical activity. Results revealed that, in line with our hypotheses, on days when participants reported more loneliness they also engaged in less moderate-to-vigorous physical activity than on less lonely days (estimate = -0.24, p = 0.007); there was a significant negative association between loneliness and daily number of steps (estimate = -18.42, p = 0.041). In contrast, at the between-person level, overall loneliness was not associated with overall physical activity engagement after accounting for within-person differences and control variables (age, sex, day in study). From an intervention perspective, our findings suggest that it is promising to tackle loneliness on a day-to-day basis to increase physical activity one day at a time. This may be especially relevant during times mandating social-distancing, but also at other times when individuals experience greater feelings of loneliness.

Mechanism of online emotional support accompany group for stress: The role of social support.

Objective: To investigate the effect of social support on stress, and to clarify the effect and mechanism of Online Emotional Support Accompany Group (OESAG). Methods: The group members who signed up for the public welfare project "Psychological Rehabilitation Group Psychological Service under the COVID-19 Pandemic" were divided into the treatment group, the control group, and the blank group with 37 members each. The treatment group received OESAG intervention, the control group received online time management group intervention, and the blank group was the waiting group. The three groups of subjects were synchronously tested before and after the intervention group. Results: After the OESAG intervention, compared with the control group and the blank group, the treatment group showed that perceived social support was improved, and loneliness and stress were decreased. Conclusion: Improving social support can effectively reduce stress. OESAG can effectively improve social support and so too decrease stress. This study could help in designing effective psychological intervention measures to reduce the degree of stress symptoms and enhance both personal and social levels of coping with stressful events.