A recent study posted to the medRxiv* preprint server assessed the impact of social isolation and loneliness during the coronavirus disease 2019 (COVID-19) lockdown.
The COVID-19 pandemic has caused a massive influx of patients into physical and mental health care facilities. Implementing national and regional lockdowns early in the pandemic to limit the spread of severe acute respiratory coronavirus-2 (SARS-CoV-2) gradually led to adverse effects on public mental health due to increased social isolation. The absence of a social buffering effect due to the pandemic could amplify psychosocial issues with possible long-term physical and psychological health consequences.
For instance, loneliness, defined as the subjective state of feeling alone, is a public health concern in modern communities with increasing social isolation and anonymity. Contrastingly, social isolation is the objective state of lacking (social) relationships and being alone. According to some studies, social isolation and loneliness are associated significantly with mental and physical health indices such as depression, psychosocial stress, generalized anxiety, a common obstructive pulmonary disorder, cardiovascular diseases, and mortality. Moreover, studies have found an association of loneliness with neuroendocrine factors (cortisol levels).
The social buffering hypothesis indicates that (social) relationships might improve both mental and physical health. Romantic relationships are intense and emotionally supportive interactions fulfil intimate needs and attachment. Such interactions with a companion could alleviate pain, stress, and psychological distress and influence immunity, the healing process, and mortality rates. Besides, single individuals have higher cortisol levels than couples, indicating that romantic relationships could decrease cortisol levels.
The current study assessed relationship status and living situation during the COVID-19 pandemic and lockdown as (potential) moderators for trait and state loneliness. The association between relationship status and trait loneliness was investigated. State loneliness and diurnal cortisol levels were assessed using the ecological momentary assessment (EMA) approach. Relationship status and living situation were thought to impact state loneliness and cortisol levels.
Participants were eligible if they volunteered and were over 18 years and fluent in German. The volunteers were required to complete online questionnaires. Loneliness scores were quantified using a German version of the 20-item University of California at Los Angeles (UCLA) loneliness scale. Participants were asked to provide salivary samples for estimating cortisol levels at six different time points for two consecutive days – after waking up, 30 minutes, 45 minutes, 2.5 hours, 8 hours post-wake-up, and immediately before sleeping. A short version of ‘partnerschaftsfragebogen (PFB)’ was used to assess relationship quality.
About 1,483 individuals consented to participate, and 1,054 volunteers completed the online questionnaires. Participants had an average loneliness score of 38.95, people in relationships and married people had the lowest loneliness scores (mean or M = 34.2). About 247 participants were included in the EMA study with salivary sampling. The mean loneliness score of EMA study subjects was 27.36. Couples living together had the lowest loneliness score of 21.42, while singles living alone had a higher score (M = 39.29).
Relationship status had a significant effect on mean cortisol levels. The mean cortisol levels were consistently higher in singles than people living with a partner. Body mass index (BMI) was correlated with cortisol levels, while the living situation had no significant correlation. Association between relationship status and momentary (state) loneliness had a substantial effect, while the association between state loneliness and living situation was insignificant. People living alone had higher state loneliness scores than those living with others (partners), and the interaction between relationship quality and living situation was insignificant.
The present research assessed the association of structural and psychological factors with loneliness and cortisol levels during COVID-19 lockdown. Consistent with previous findings, the authors found that an affectionate relationship or living with a partner could be protective against loneliness and cortisol levels (neuroendocrine stress responses). Trait loneliness was the highest in divorced or widowed individuals than singles indicating that the loss of partner or romantic support was associated with loneliness. Relationship quality did not moderate the association between loneliness and living situations.
The observations made in the study highlight the protective effect of living together regardless of relationship quality during the COVID-19 lockdown. Arguably, females reported higher trait loneliness levels than males, adding to the mounting evidence that females are at a higher risk for loneliness.
Notably, the current evaluations were made without baseline parameters (controls) such as pre-COVID-19 lockdown analysis of cortisol levels and loneliness. Therefore, these findings are representative only of the COVID-19 lockdown period.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.