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Psychological Impact of the Pandemic: Part One

Dr. Brian Stagner, TPA Director of Professional Affairs, Associates for Applied Psychology

 

This four-part series is offered to summarize what we know about the psychological responses to the present crisis. It covers the effects of quarantine and the effects of economic downturns, how to help clients and the public, and concludes with ways to lead during and after the pandemic.

 

Part One

 

The Effects of Quarantine

Most of the country is living with some sort of restrictions or admonitions to contain exposure to the virus. Social distancing, sheltering in place, and formal lockdowns are “softer” forms of quarantine. The research on the effects of quarantine may be helpful to providers whose patients are suddenly adapting to self-isolation (e.g., Brooks, et al, 2020). Some highlights follow:

 

During the quarantine

Effects on children are especially pronounced, with quarantined children having as much as four times the rate of PTSD than children who were not quarantined.

Effects on adults. Not surprisingly, studies have reported elevations in all negative emotions, including anxiety, fear, sadness, and anger.

 

After the quarantine

Three year follow up suggests that an increase in alcohol dependency was positively correlated with having been quarantined among health care workers.

After the quarantine was lifted avoidance behaviors persisted, including avoiding crowds, avoiding people with illnesses, and staying away from work.

 

Healthcare workers and first responders

After the quarantine healthcare workers appear to have been much more deeply affected and for a longer period in comparison to the general population.

 

Stressors: Factors contributing to the impact of quarantine

There is very little research on the effects of the duration of the quarantine. One study found that those quarantined for more than 10 days showed significantly higher PTSD symptoms. This is a concern because while self-isolation may not be as stringent as a formal quarantine, it may last significantly longer.

Fears around infection include fear for one’s own health, worries about the health of loved ones, fear of potentially toxic environments (e.g. the grocery store), and fear that one might be a vector that could infect others. For some people, guilt will follow the fear. Anecdotal evidence suggests that patients may not easily articulate it.

Boredom and loneliness will be a problem for everybody. Even the most introverted will experience disruptions in their social networks.

Loss of structure and routine is often overlooked as a stressor, particularly in the early phase of self-isolation. Although we fantasize about all that could be accomplished with “free time”, many of us are ill-prepared to stay organized without external prompts and guideposts. As the isolation period grows longer, successful adaptation recalibrating to establish new routines to facilitate working from home, maintaining domestic harmony, and most importantly, renewing self-care efforts. More broadly, robust routines bolster self-efficacy.

Shortages (food, medication, fuel, paper goods, protective gear, etc.) is, of course, a major stressor during the acute phase of a quarantine. Anxiety and anger about such shortages may persist as long as six months after the quarantine period ends.

Inadequate information is widely cited across many studies as a major stressor. Lack of clarity about risk, lack of transparency from authorities about pandemic severity, and lack of clear protocols or guidelines all contribute to overall distress.

Media overexposure is corrosive. Instant access to sometimes unreliable news, and 24/7 coverage is not helping. When there has already been substantial distrust of both the media and the authorities, the prevalence of alarming information serves only to heighten subjective stress without prescribing any plan of action.

Financial losses are affecting most households. Loss of salary and wages and devaluation of investments are an immediate stressor for many. Many families have already been living paycheck to paycheck before the crisis and their crunch is immediate. Fear and distress will escalate as the economic downturn lingers on. There will be government efforts to support individuals and businesses, many will feel that the amount is insufficient, that it comes too late, and that it has been unfairly allocated.

 

References

Brooks, S.K., Webster, R. K., Smith, L. E., Woodland, L, Wessely, S., Greenberg, N., & Rubin, G. J. (2020). The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet 2020 395:912-920. Published online February 20, 2020. https://doi.org/10.1016/S0140-6736(203)30460-8

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Dr. Brian Stager is the Director of Professional Affairs at the Texas Psychological Association. He also serves as an American Psychological Association Council Representative. He is a therapist in Bryan/College Station.

 

Read Part Two

 
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