Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 3, 2021
Date Accepted: Dec 12, 2021
Date Submitted to PubMed: Feb 22, 2022
COVID-19 lockdown increases the temporal dynamic impact of loneliness on daily activities, cognitions, and stress in a lonely and distressed population
ABSTRACT
Background:
The COVID-19 pandemic and its associated lockdown measures impacted mental health worldwide. However, temporal dynamics of causal factors that modulate mental health during lockdown are not well understood.
Objective:
The main objective of the study was to understand how a COVID-19 lockdown changes the temporal dynamics of loneliness and other factors affecting mental health.
Methods:
We combined ecological momentary assessments (EMA) with wrist-worn motion tracking to investigate the mechanism and changes in network centrality of symptoms and behaviors before and during lockdown. 258 participants were assessed 8 times a day for 7 consecutive days over a 213-day period from 8 August 2020 through 9 March 2021 in Germany, covering a “no-lockdown” and a “lockdown” stage. COVID-19 related worry, information seeking, perceived restriction and loneliness were assessed by digital visual analogue scales ranging from 0 -100. Social activity was assessed on a 7-point Likert scale, while physical activity was recorded from wrist-worn actigraphy devices.
Results:
We built a multilevel vector autoregressive model (mIVAR) to estimate dynamic networks. To compare network characteristics between a no-lockdown stage and a lockdown stage, we performed permutation tests. We found loneliness played a prominent role in networks across these two stages, as indicated by its centrality index (i.e., an index to identify a central variable that has a strongest influence on the other variables). During lockdown, the centrality of loneliness was significantly increased. Physical activity contributed to a decrease in loneliness amid the lockdown stage.
Conclusions:
The COVID-19 lockdown increased the central role of loneliness affecting negative cognitions and stress. Loneliness may be a prime candidate for intervention, as loneliness was found to be the most important trigger for consecutive negative mental health changes during lockdown. Physical activity can serve as a buffer for loneliness amid social restrictions.
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