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      Loneliness in the Era of COVID-19

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      Frontiers in Psychology

      Frontiers Media S.A.

      COVID-19, social connectedness, loneliness, well-being, mental health

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          Abstract

          COVID-19 is proving to be a particularly cruel disease not just because of its pathophysiology but also due to its potentially devastating consequences for engendering loneliness. From the outset of the pandemic, we have learned of countless individuals having to die alone or loved ones not being able to grieve by providing burial services (Miller, 2020). This disease holds particularly dire consequences for many populations—most notably the elderly and those with compromised health conditions but also minorities and the homeless; these groups have also faced unique difficulties in contending with loneliness well before this crisis (Rokach, 2019). For as much attention that this disease has rightfully focused on the elderly, individuals can experience different developmental challenges with loneliness throughout the lifespan including adolescence and young adulthood (Luhmann and Hawkley, 2016)—and, indeed, there is already evidence of heightened psychological problems amongst Chinese youth in the wake of this pandemic (Liang et al., 2020). Accordingly, it will be important for psychologists to assess how age-based threats to loneliness evolve in the era of COVID-19. Social distancing and isolation are critical to preventing the transmission of this highly contagious virus; yet, these are acts that are intrinsically linked with various adverse psychological effects including loneliness and adherence to these sorts of strategies are likely to decrease over time (Armitage and Nellums, 2020; Galea et al., 2020). Given the great reliance on technology during this time, it has been suggested that devices like smartphones can help combat isolation and loneliness during the pandemic particularly among the elderly (Banskota et al., 2020). However, there is a rather conflicting literature as to how Internet-based and social media usage impacts loneliness (Miller, 2018). For instance, Kim (2020) found that social media discussions about COVID-19 were less likely to feature uncivil comments amongst South Korean users with larger social networks. In short, it would be inaccurate to presume that technology provides an absolute clear means of minimizing feelings of loneliness during this crisis. Even before the pandemic, the World Health Organization declared that social disconnection was a major public health crisis and there is growing concern that the lonely and socially isolated may face heightened morbidity and mortality risks including suicide as a result of this crisis (Courtet et al., 2020). Much more research needs to be done with respect to possible direct or indirect effects from this pandemic that have either created newly found feelings of loneliness or reduced previous such feelings. On one hand, in the wake of this crisis, consistent with basic themes from both terror management theory and attachment theory, a fear of loss of loved ones and love itself should produce a fundamental sense of fear so as to potentially bolster earlier bonds (Steele, 2020). Yet, we are facing what many are terming alarming rises of upwards of 10–20% increased year-to-year rates of domestic violence in select U.S. cities in the immediate aftermath of the crisis (Boserup et al., 2020). More generally, this pandemic may adjust our appraisals of others as they relate to our perceptions of loneliness as it has also served as a reminder of the importance of maintaining health and the fragility of life. Accordingly, it is possible that this crisis may cause individuals to reevaluate aspects of their lives that have contributed to prior perceptions of loneliness. Though, in this era of social distancing and quarantining, quite notably, the sheer act of being alone is not inherently tantamount to producing loneliness (Russell et al., 2012) nor does the physical company of others (such as spouses) inherently prevent loneliness either (Moorman, 2016). This pandemic will also likely cause us to reflect about our physical environments in a more thoughtful way and this too will have significant relevance to the study of loneliness. A classic paper from Milgram (1970) examined the irony of how urban life can actually allow individuals to feel disconnected from others. Indeed, even though much of the industrialized world is largely urban, such environments can pose challenges to loneliness due to their design and the psychological effects of dense living (Imrie, 2018). The need to address these challenges has likely grown given the newfound perils of physical proximity to others that is largely synonymous with urban life. And, though it may not necessarily be tied to loneliness experienced vis-à-vis close others, feeling connected to nature appears to be associated with a larger connection for humanity and others (Moreton et al., 2019). Since the original COVID-19 source almost certainly was a bat and the point of transmission from animal to human likely occurred at the Wuhan Seafood Market, this experience should force us to realize that in our interdependent world, our actions have clear global consequences and it is critical to have health policies with environmental regulations. In doing so, while it is fair to critique governmental policies or responses that may have contributed to this crisis, it is also important to not do so in a way that further foments racism or stigmatization (Ang, 2020) as these conditions are also associated with the promotion of loneliness. Over the course of human history, individuals have borne witness to various atrocities and disasters such as war, genocide, and pandemics—and individuals and society generally adapt to these conditions. However, though there remains some debate whether loneliness should be viewed as a modern epidemic, Alberti (2019) contends that it should be looked at it this way when considered through a historical lens and particularly since in the twenty-first century, it is often intertwined by broader social, economic, and political crises. The COVID-19 pandemic features all of these aforesaid crises (Miller, 2020). Though COVID-19 may hold some unique consequences for perceptions of loneliness, so does the potential for technology to help foster self-care during this crisis (Saltzman et al., 2020). Some of the common reasons why loneliness may occur (such as distance from close others or feeling alienated) or ways we cope with loneliness (such as increased activity) may be hindered due to the nature of the pandemic; likewise, pre-existing mental, and physical health risks of loneliness may be exacerbated too during this pandemic. But, indeed, there are effective techniques (that do not necessarily require an online component) such as increased self-reflection and acceptance that can potentially be utilized during this crisis (Sønderby and Wagoner, 2013). Psychological theory, practice, and research must accordingly work to address what will likely be an ever-burgeoning loneliness crisis in the coming years as a result of this pandemic. Author Contributions The author confirms being the sole contributor of this work and has approved it for publication. Conflict of Interest The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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          Most cited references 18

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          The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention

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            COVID-19 and the consequences of isolating the elderly

            As countries are affected by coronavirus disease 2019 (COVID-19), the elderly population will soon be told to self-isolate for “a very long time” in the UK, and elsewhere. 1 This attempt to shield the over-70s, and thereby protect over-burdened health systems, comes as worldwide countries enforce lockdowns, curfews, and social isolation to mitigate the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, it is well known that social isolation among older adults is a “serious public health concern” because of their heightened risk of cardiovascular, autoimmune, neurocognitive, and mental health problems. 2 Santini and colleagues 3 recently demonstrated that social disconnection puts older adults at greater risk of depression and anxiety. If health ministers instruct elderly people to remain home, have groceries and vital medications delivered, and avoid social contact with family and friends, urgent action is needed to mitigate the mental and physical health consequences. Self-isolation will disproportionately affect elderly individuals whose only social contact is out of the home, such as at daycare venues, community centres, and places of worship. Those who do not have close family or friends, and rely on the support of voluntary services or social care, could be placed at additional risk, along with those who are already lonely, isolated, or secluded. Online technologies could be harnessed to provide social support networks and a sense of belonging, 4 although there might be disparities in access to or literacy in digital resources. Interventions could simply involve more frequent telephone contact with significant others, close family and friends, voluntary organisations, or health-care professionals, or community outreach projects providing peer support throughout the enforced isolation. Beyond this, cognitive behavioural therapies could be delivered online to decrease loneliness and improve mental wellbeing. 5 Isolating the elderly might reduce transmission, which is most important to delay the peak in cases, and minimise the spread to high-risk groups. However, adherence to isolation strategies is likely to decrease over time. Such mitigation measures must be effectively timed to prevent transmission, but avoid increasing the morbidity of COVID-19 associated with affective disorders. This effect will be felt greatest in more disadvantaged and marginalised populations, which should be urgently targeted for the implementation of preventive strategies.
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              The Effect of COVID-19 on Youth Mental Health

              The purposes of this study was to assess the youth mental health after the coronavirus disease 19 (COVID-19) occurred in China two weeks later, and to investigate factors of mental health among youth groups. A cross-sectional study was conducted two weeks after the occurrence of COVID-19 in China. A total of 584 youth enrolled in this study and completed the question about cognitive status of COVID-19, the General Health Questionnaire(GHQ-12), the PTSD Checklist-Civilian Version (PCL-C) and the Negative coping styles scale. Univariate analysis and univariate logistic regression were used to evaluate the effect of COVID-19 on youth mental health. The results of this cross-sectional study suggest that nearly 40.4% the sampled youth were found to be prone to psychological problems and 14.4% the sampled youth with Post-traumatic stress disorder (PTSD) symptoms. Univariate logistic regression revealed that youth mental health was significantly related to being less educated (OR = 8.71, 95%CI:1.97–38.43), being the enterprise employee (OR = 2.36, 95%CI:1.09–5.09), suffering from the PTSD symptom (OR = 1.05, 95%CI:1.03–1.07) and using negative coping styles (OR = 1.03, 95%CI:1.00–1.07). Results of this study suggest that nearly 40.4% of the youth group had a tendency to have psychological problems. Thus, this was a remarkable evidence that infectious diseases, such as COVID-19, may have an immense influence on youth mental health. Therefor, local governments should develop effective psychological interventions for youth groups, moreover, it is important to consider the educational level and occupation of the youth during the interventions.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                18 September 2020
                2020
                18 September 2020
                : 11
                Affiliations
                Department of Psychology, Kent State University , East Liverpool, OH, United States
                Author notes

                Edited by: Ami Rokach, The Center for Academic Studies, Israel

                Reviewed by: Idit Shalev, Ariel University, Israel

                *Correspondence: Eric D. Miller edmille1@ 123456kent.edu

                This article was submitted to Personality and Social Psychology, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2020.02219
                7530332
                f00d5ef5-50f9-4f03-83b2-a6dca8421a65
                Copyright © 2020 Miller.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 3, Words: 1801
                Categories
                Psychology
                Opinion

                Clinical Psychology & Psychiatry

                covid-19, social connectedness, loneliness, well-being, mental health

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