The mediating role of Hope between Loneliness and Anxiety during Covid-19 among younger adult (18-25) and older adults (65-80)
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Since December 2019, the lives of people all around the globe have been altered because of severe Acute Respiratory Syndrome Coronavirus-2 followed by COVID-19 pandemic. As of today, more than 177 million people worldwide have been tested positive for this virus where 3 million people have lost their lives while medical professionals report that actual number is much higher than this (https://COVID-19.who.int/). Because of this novel condition, people for the first time in their lives faced forced and prolonged self-isolation which is against the human nature. While the social isolation has been especially intense for older and younger adults who had potential contact with the virus. Going against the nature always has consequences and as day-by-day new vaccines are rolling, people are going back to normal life, yet it does not free human from the psychological effects such as anxiety, uncertainty and loneliness they experienced during COVID-19. These psychological consequences of COVID -19 will likely persist in society even after the pandemic ends as the physical restriction will impact the psychological well-being of individuals (Leigh-Hunt & Colleagues, 2017). Same trends have been seen in past where there has been evident surge in anxiety and depressive disorders during SARS in 2003 (Cheung et al., 2008), similar effects were seen during Ebola epidemic in 2014-2016 (Jalloh et al., 2018) and currently due to induced loneliness, increase in depression and anxiety disorders was also predicted with further growth in future yet more studies are needed to see the influence of loneliness on anxiety and other factors playing their role to influence this relation.
Despite of being a neighbor of country from where the pandemic of COVID-19 started, Hong Kong reported much less positivity rate (11,881 cases) and mortality (210 cases)
Human is considered as social animal. Since early years philosophers and psychologist have narrated that by being lonely, human depicts the fundamental failure of achieving the sense of belongingness with their loved ones and in the world, which impacts their capacity of maintain wellbeing (Baumeister & Leary, 1995). Loneliness has been defined in the literature using various definitions, yet all the definitions of Loneliness have three vital components (Peplau & Perlman, 1982). The features are:
A) loneliness is a byproduct of perceived lack of social skills
B) it is subjective
C) loneliness is a negative and painful experience which cause significant distress
However, for this study the definition by Perlman and Peplau (1982) is considered which defines loneliness as “the negative emotional response to a discrepancy between the desired and achieved quality of one’s social network”. This definition states that the discrepancy between actual and desired social skill is the basic reason behind loneliness. Also, this definition contains both the affective and the cognitive factors pertaining to the loneliness and differentiates the construct of solitude, where solitude is an objective and a positive state while loneliness is a subjective and negative state (Goosens, 2006; Goossens & Marcoen, 1999). Ample of research showed that loneliness is linked with unpleasant and distressing experience and have adverse psychological outcomes (Rokach, 2012). It has also been linked with decline in cognitive abilities and early advent of dementia among older adults (Cacioppo et al., 2010). Similarly, loneliness among adolescents is linked with low self-esteem which becomes more evident in adulthood (Mustaq et al., 2014). Associations of loneliness with mental health conditions such as increased perceived stress, constant fear of being negatively evaluated, anxiety, anger, high pessimism and diminished self-esteem has been also highly reported as well (Hawkley & Cacioppo, 2010). However, the level of loneliness is different among age groups and follow a certain trajectory (Heinrich & Gulline, 2006).
Loneliness tends to follow a “U” curve in its trajectory. Loneliness has been said to reach at its peak in adolescence, then decrease in middle adult hood and surge again in elderly (Heinrich & Gulline, 2006). However, the literary evidence to provide concrete information on trajectory of loneliness is still scarce, but the literature up till now showed that loneliness scores are rather low and stable from kindergarten to 6 years of age (Kochenderfer-Ladd & Wardrop, 2001). The same pattern is followed from age 7 to 12 years (Bartels, Cacioppo, Hudziak, & Boomsma, 2008). After this time, the decline in loneliness was observed from early to middle adolescence (Van Roekel et al., 2010) and then increased significantly in later years of life. However, there is lack of longitudinal research pertaining to adolescent to young adulthood. The interesting part is this phase of life is linked with various social challenges and making new friends is somewhat normal. Based on this information, it is assumed that individual is less lonely during this phase of life
During Covid-19, the level of loneliness among all ages increased owing to social isolation. Preliminary studies conducted on Chinese and Italian population reported high prevalence of PTSD, anxiety, depression and stress among COVID survivors (Bao et al., 2020; Rossi et al., 2020). Also, pre and post pandemic studies have pointed towards the impact of social isolation in form of increased mental health issues among general population (Gao et al., 2020) and showed association of loneliness with depression and anxiety (Killgore et al., 2020). Elevated levels of depression, stress, anxiety and loneliness were reported among Hong Kong residents as well (lee et al., 2020;
Anxiety can be viewed as the perceived inability to predict or control the outcome of the situation which results in subjective perception of the event being a threat and accompanying negative effect. Anxiety emerges as a consequence of interaction between individual and the environment. Irrespective of loneliness, anxiety has cognitive, psychological and behavioral component (Konstam, Moser, & De Jong, 2005). Studies have shown that with increased isolation and lack of social contact significantly increases the anxiety levels. It is argued in literature that perhaps loneliness is the reason behind anxiety (McWhirter, 1990). Recent research has also reported anxiety as a byproduct of loneliness (Hawkley & Cacioppo, 2010; Heinrich & Gullone, 2006). Similarly chronic anxiety can have significant impact on physical health and is related to quality of life, mortality and depression. Because of this Loneliness has been proven a significant risk factor for depression, anxiety and its comorbidity during COVID-19 (Plagi et al., 2020). Similarly, Holmes (2020) suggests that social isolation and loneliness are strongly associated with anxiety across the lifespan. When such feelings like loneliness and increased anxiety levels during the pandemic is not well coped, a bigger mental health issue could be triggered. Hawryluck (2004) has shown that 29% of 129 interviewee who were put in quarantine were later diagnosed PTSD and depression after the SARS outbreak in 2003. Similarly Meterns et al., (2020) reported link between fear of COVID-19 and anxiety which later lead to depression. It can be said that fear of Covid is associated with higher anxiety scores as compared to depression scores (Mamun and Griffith, 2020) which point towards the need of exploring this construct in various population. Owing to cultural differences (collectivist vs individualistic society) it was expected that South Asian population will have higher levels of anxiety and depression as compared to European countries. Study showed moderate to severe level of anxiety symptoms were present among Chinese population (Huang and Zhao, 2020). However it is possible that education and age of individual may result in different output as Study by Chen et al., (2020a) showed undergraduate students being more fearful of covid with high scores in anxiety as compared to graduate students. Similarly when viewed anxiety within context of Covid-19 and loneliness associated with it. 56.4% adults reported perceived isolation while 36% of adults reported loneliness. However, study showed no relation between COVID-19 related anxiety and social isolation which perhaps point towards the argument that perceived isolation of COVID-19 may exacerbate the already present clinical symptoms but it may not be a predisposing factor of anxiety among older population (Gaeta & Brydges, 2020). According to Wong et al., (2021) it is worth looking at other moderating variables that might be mitigating the relationship between the two variables (loneliness and anxiety) and proposed that the amount of information consumed from social media is directly related to the levels of COVID related anxiety among older adults. As the COVID has pushed the older adults to be in isolation and with no human contact they relied heavily on the social media for updates which might have consequently increased the levels of anxiety among adult population (Wong et al., 2021). No studies are found among younger adults and their level of anxiety within context of COVID loneliness. However, it is possible that younger adults mostly have families (wife and kids) with whom they were isolated which might have mitigated their levels of anxiety as low as compared to older adults. However, further researches are required to confirm or reject this hypothesis. Nevertheless, some individuals have positive psychological strengths that allow them to resist anxiety and loneliness (Karababa, 2020). Hope has been studied extensively in this context (Schofield, Stockler & Zannino et al., 2016).
Human behaviour is motivated by the identification and pursuit of goals and define hope as “pathways thinking, or the capacity to identify strategies to pursue one’s goals and agency thinking, or the motivation to effectively pursue one’s pathways to achieve goals” (Snyder, 2002). The factors mentioned in the definition are bidirectional in nature and enhance the motivation and promote the goal directed movement. As in past there has been number of models proposed but the model given by Snyder (1991) was most compelling. According to Snyder all human put an effort to move towards the goal on basis of Hope. It is a universal process that involves conscious efforts and extend psychological advantages to all(Lopez, 2013; Snyder, 1994; Snyder et al., 1991). Snyder theory have been supported by empirical evidence as well and mention it as adaptive process specially among adults (e.g., Snyder, 1994, 2002; Snyder et al., 1991). Many studies in past have reported hope as the buffer between the relation of maladaptive processes and unhappy conditions in adults. Muyan et al. (2016) In his study found that hope is the significant predictor f depression and interaction of loneliness and hope presicts the anxiety symptoms and not the depressive. However, for concrete results, further replication would be required.
According to Snyder et al. (1991), hope reflects a cognitive set composed of two relatively distinct ways of thinking about a goal as measured by their Hope Scale. Agentic thinking involves thoughts related to one’s successful determination or resolve about reaching goals, whereas pathways thinking involves thoughts about one’s effective ability to pursue different means to obtaining goals. Within Snyder et al.’s (1991) hope theory, it is important to consider both types of cognitions as they relate to behavior and outcome. Accordingly, an important tenet of Snyder’s (1994) model is that the perception of goal attainment will be, in general, positively associated with greater levels of both agentic and pathways thinking, which in turn will result in each of the hope components being associated with psychological adjustment (e.g., greater life satisfaction). Indeed, findings from a number of studies examining Snyder et al.’s (1991) measure of hope have consistently provided support for a two-dimensional model (e.g., Babyak, Snyder, & Yoshinobu, 1993; Gana, Daigre, & Ledrich, 2013; Gomez et al., 2015; Kato & Snyder, 2005; Martos, Lakatos, & Tóth-Vajna, 2014; Roesch & Vaughn, 2006; Sun, Ng, & Wang, 2012).
Hope is related to various psychological constructs such as resilience, self-efficacy, and hope. There is a significant literature that suggests relation between high levels of hope and low levels on anxiety. It can be said that hope lets an individual to solve problems in better ways in the face of adversity. A study conducted on French population showed negative correlation between hope and anxiety (Gana, Diagre, & Ledrich, 2013). Similar findings were seen in Saudi Arabia as well ( Abdel-Khalek & Snyder, 2007). Few studies pointed towards negative association of hope, optimism and wellbeing in face of COVID stress among college students and emphasized that being hope full is a potential source of high scores on wellbeing among Younger adults (Genc & Arsla, 2021)
While studying the moderating role of anxiety with social isolation and wellbeing among adolescents, no effect was found which indicate that chaos and uncertainty adolescent faced during COVID-19 is much greater than the hope influencing relation between loneliness and anxiety. However, the study was limited to 12-14 years of age group and cannot be generalized over older or younger adult population (Huack, 2020). However, there is a gap in literature which explores the impact of pandemic on the younger adults and its relation to the loneliness, anxiety and hope and how hope play its role to alleviate the levels of anxiety during Global Pandemic (Mirhosseini et al., 2020).
This study aims to look at the moderating role of hope in relation between loneliness and anxiety while comparing the levels among younger and older adults in Hong Kong. The analysis between two age groups will also help to see the trajectory and trends of the loneliness, anxiety and hope. This study where it will validate the results of previous studies conducted with adults, while adding incremental value by exploring these factors among younger adults which is a neglected population within context of COVID pandemic.
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