The Impact of Social Isolation on Pandemic Stress and Aggressive Behavior of Adolescents during the COVID-19 Period

Uka V and Beka D

Published on: 2023-04-02

Abstract

Background: Since the beginning of the Covid-19 pandemic, adolescents have experienced drastic changes in their lives, this change has had adverse effects especially during social isolation, which has affected stress levels and behavioral changes.

Objective: The objective of the work was to analyze the impact of social isolation on adolescent life, especially on measuring the level of stress and aggressive behaviors during the Covid-19 Pandemic period.

Methods: Research was conducted through an online survey using the stress questionnaire and aggressiveness questionnaire using the snow ball sampling method, which is one of the methods of non -random sampling. The target population of the study is: Persons of adolescent age at least 18 years old and at the same time Kosovo citizens. The research was attended by 220 participants, 115 females and 105 males and was realized in July-September 2020.

Results: Data analysis is performed through SPSS. Spearman correlation analysis shows that the impact of social insulation by Covid-19 has an important positive correlation with aggressive stress and behavior. Thus, the correlation between the impact of social insulation and stress is (r = .763; p = 0.00), the correlation between social insulation from Covid-19 and aggressive behavior is (r = .643; p = .000), i.e. with increasing Social isolation from Covid-19 also increases the level of stress and aggressive behavior.

Conclusions: From the results of the study we conclude that social isolation during the Pandemic period has influenced the emergence of high levels of stress and adolescents during social isolation exhibited higher levels of verbal aggression, followed by anger, followed by physical violence and hostility. These obtained results can serve as recommendations for state leaders regarding the management of the situation based on the analyses taken.

Keywords

Impact; Covid-19; Social isolation; Stress; Adolescent; Aggressive behavior; pandemic

Introduction

The SARS-CoV-2 pandemic placed many countries under "stay at home" orders, and adults were simultaneously subjected to a form of social isolation that is unprecedented in the modern world. This was after several months of similar quarantine orders in countries throughout Asia and Europe. As a result, a unique situation arose, in which most of the world’s population was confined to their homes, with only medical staff and other essential workers being allowed to leave their homes on a regular basis. The experience of adolescent stress constitutes an issue of central importance to the understanding of adolescent health [1]. Several studies of previous quarantine episodes have shown that psychological stress reactions may emerge from the experience of physical and social isolation [2]. In addition to the stress that might arise with social isolation or being restricted to your home, there is also the stress of worrying about contracting COVID-19 and losing loved ones to the disease [2].

The History of Kosovo

Kosovo, officially the Republic of Kosovo, is an independent state in South Eastern Europe. It lies in the center of the Balkan Peninsula and is bordered to the north and east by Serbia, to the southeast by North Macedonia, to the southwest by Albania and to the west by Montenegro. It has an area of 10,887 km² and a population of 1.9 million inhabitants. [8] The vast majority of the population is Albanian, while other minorities include Serbs, Turks, Bosnians, Roma, /Egyptians, and Gorani [9].

Demography of Kosovo

The last full population census was done in 1981, when Kosovo had 1,584,000 inhabitants. Estimates from 2011 put the population at 1,733,872, while other sources put the figure at 2,200,000 [61]. American intelligence sources put the figure at only 1,804,838, according to the latest estimate of July 2009 [8]. The exodus of Kosovars during this period, as well as those killed during the war, have hindered the expected growth of the population, despite the natural increase of 12.7 per 1,000 inhabitants.

Settlements of Kosovo

Kosovo has a total of 1,466 settlements, which are distributed in 30 municipalities. Municipalities with over 70 settlements: Gjakove 88, Peje 79, Besiane 77, Prizren 77, Dardane 76, Leposaviq 75 and Lypjan 70. Municipalities with 40-70 settlements: Vushtrri 67, Gjilan 63, Zubin Potok 61, Kline 54, Burim 50, Skenderaj 49, Prishtina 49, Mitrovica 47, Ferizaj 45, Malisheve 44, Viti 43, Kaçanik 42, Therande 41 and Decan 40. Municipalities with less than 40 settlements: Sharr 36, Rahovec 36, Drenas 35, Zvecan 35, Shtime 23, Obiliq 20, Fushe Kosove 18, Shterpce 16 and Novoberde 10.

The primary language spoken in Kosovo is the north eastern Ghega dialect of the Albanian language, spoken as a mother tongue by Albanians and Ashkali and as a second language by most other nationalities, with the exception of Serbs who have less knowledge.

In addition to the high natural increase mentioned above, Kosovo enjoys a very young population. The average age is 25.9 years [8], 70% of the population are under 30 years old, while 33% belong to the age group 0-14 years and only 6% are over 65 years old. Average life expectancy is 69 years; women live nearly 71 years, 4 more than men. The birth rate is 16.3‰, while the mortality rate is 3.6% [9].

Primary education in Kosovo takes place in five languages- Albanian, Serbian, Bosnian, Turkish and Croatian- and is compulsory and free in public schools for all citizens.

During the academic year 2011/2012, in Kosovo there were 24,945 students in pre-primary education, 161,624 in primary education, 132,795 in lower secondary education, as well as 109,513 in secondary education institutions. The needs of these students were met by 1,333 teachers working in pre-primary education, 7,700 in primary education, 10,122 in lower secondary education, and 6,095 in secondary schools. Meanwhile, only 138 teachers worked with 703 students with special needs in primary education and 51 with 94 students in special secondary schools. After the war, a number of private schools were opened.

Adolescent and COVID-19

Adolescence is the phase of life between childhood and adulthood, from ages 11 to19. This is a unique stage in the life of a human being for laying the foundations of good health. Adolescents experience rapid physical, cognitive and psychosocial growth .This influences the way they feel, think, make decisions, and interact with the world around them. Adolescence is a sensitive period for social development with an increased need for social connections [7]. Coping with the present situation and following the current restrictions on top of this can be especially difficult for children and adolescents since these circumstances can be experienced as being incongruent with their developmental tasks. The challenges and consequences of COVID-19 might therefore have a tremendous impact on their health-related quality of life and mental health. The covid-19 is no exception. Both parents and teens report adviser mental health effects of the pandemic on adolescents, including symptoms of stress, anxiety and depression.

For most of adolescent, the physical restrictions have decreased in-person social interaction. They have also led to increased adaption problems in adolescents. Adolescents and young people are at lower risk of critical COVID-19 symptoms, but the strict confinement orders demanded significant changes in daily routines and social interactions [8].

According to studies in Kosovo, teenagers during social isolation have been found to highlight the level of concerns and other changes in (students), children and families.

According to the perspective of the parents, during the period of isolation, it was observed that the children had changes in behavior, they were afraid (showed signs of panic), depressed, stressed, fearful, anxious, confused and passive, and aggressive behavior. Changes have also been observed within the family: increased levels of stress and anxiety, increased fear, pressure, and changes in sleep patterns. Also, the impossibility of personal space and activities that are only theirs, which under normal conditions is achieved by going to school and through contact with peers, has a great impact on children [9].

Social Isolation

Social isolation can be defined structurally as the absence of social interactions, contacts, and relationships with family and friends, with neighbours on an individual level, and with “society at large” on a broader level. The most parsimonious definition of social support is “the resources provided by other persons”. Social isolation is a multi-dimensional construct that can be defined as the inadequate quantity and/or quality of interactions with other people, including those interactions that occur at the individual, group, and/or community level [11].

Some measures of social isolation focus on external isolation which refers to the frequency of contact or interactions with other people. Other measures focus on internal or perceived social isolation which refers to the person’s perceptions of loneliness, trust, and satisfaction with their relationships. This distinction is important because a person can have the subjective experience of being isolated even when they have frequent contact with other people and conversely they may not feel isolated even when their contact with others is limited. For many families, this stress is compounded by the challenge of working from home while also caring for children whose schools had been closed in an effort to slow the spread of the disease. While the effects of social isolation has been reported in the literature, little is known about the effects of social isolation during a global pandemic [12].

Aggressive Behavior during the Time Covid-19

The Covid-19 pandemic has brought unprecedented challenges to people’s lives, threatening their health, economic livelihoods, freedom of movement, and – not least – their social relationships. It is too early to gauge how fundamental and lasting these challenges will be, but we already see major changes in the way people live together in families, social groups, and societies at large. As an aggression researcher, I am particularly concerned about the potential impact of the pandemic on people’s tendencies to show aggressive behavior, defined as behavior carried out with the intention to cause physical or psychological harm to others. From a social psychological perspective, there are several “ingredients” of the current situation that are conducive to aggression:

  • The first is uncertainty, which relates to the probability of an infection and the potential severity of the illness at any given point as well as to the length of time before we will be able to resume a “normal life”. Uncertainty creates stress, and stressed people are more likely to show aggressive behavior, not least because coping with stress requires resources, such as self-control, that are needed to inhibit aggressive behavior.
  • A second, related ingredient is lack of control, which violates humans’ vital need to live in a predictable and safe environment. If restoring control is not possible at the factual level – the virus does not go away – it needs to be restored at the psychological level, which makes people susceptible to accepting simple truths or denying the risk and willing to attack anyone who challenges their position.
  • Third, the current situation is characterized by a seemingly endless list of frustrations. Several prominent theories of aggression consider frustration, defined as the blocking of a goal-directed action, as a powerful instigator of aggression. One source of frustration for many people is that they are forced to spend most of the time at home, and we are already seeing increased rates of violence against children and intimate partners.
  • Fourth, social distancing rules may promote a sense of loneliness and social exclusion that threatens another vital motivation, the need to belong. Experiments have shown that the desire to be included in social interactions is so strong that people respond with aggression even when they think they are excluded by a random computer algorithm or by a group they strongly dislike [13].

Relevant Research

The COVID-19 pandemic seems to have had a negative psychological impact on the entire population. Due to the sudden appearance of the virus, the high level of transmissibility, the lack of vaccines or drugs to cure the virus in the first months, and the fear of the unknown regarding the consequences of the virus, various mental health problems developed such as are anxiety, depression, stress, aggressive behavior and other psychological disturbances.

Although there are fewer studies with young and middle aged adults, there is some evidence of a similar pattern of greater isolation being associated with negative psychological outcomes for this population [14]. There is also considerable evidence that social isolation can have a detrimental impact on physical health. In a meta-analysis of 148 studies examining connections between social relationships and risk of mortality, Holt-Lunstad concluded that the influence of social relationships on the risk for death is comparable to the risk caused by other factors like smoking and alcohol use, and greater than the risk associated with obesity and lack of exercise. Likewise, other researchers have highlighted the detrimental impact of social isolation and loneliness on various illnesses, including cardiovascular, inflammatory, neuroendocrine, and cognitive disorders [15].

Understanding behavioural factors related to positive and negative copings is essential in providing health guidance to adult populations. According to Zandifar and Badrfam, in an attempt to understand the effects of the pandemic on the population, they pointed out that unpredictability, lack of security, risk of infection, misinformation from the media and social isolation, were factors that contributed to the increase in the level of stress and other psychological problems even in teenagers. These authors went further and suggested that in order to reduce the negative consequences of the pandemic, mental health services should be increased, especially among adolescents, as well as increased social engagement in coping with the situation. [16].The main objective of this study was to analyse the impact of social isolation on the life of teenagers, especially on the level of stress and aggressive behavior during the period of the Covid-19 pandemic. The dependent variables were pandemic stress and aggressive behavior, while the independent variables were gender, age, social isolation.

Methodology

Participants

The sample of the study consisted of 220 participants from the entire territory of Kosovo who belong to the teenage age, starting from the age of 13 to 21 years. The survey method was online survey; the respondents were informed that their participation is free and voluntary and if they change their mind they can withdraw. The consent and approval of parents and adolescents is taken to be part of the study. They voluntarily agreed to participate in the study, however, permission was obtained from their parents online for the teenagers to be part of the study, but they were also informed in advance that confidentiality would be maintained. The data was collected from July to September 2020. We used the quantitative method for this research. The design of this study is correlational.

Instruments

The study was conducted with a questionnaire regarding socio-demographic variables, then the Adolescent Stress Questionnaire (ASQ-N) and the aggressive behavior (The Aggression Questionnaire; AQ) in adolescents. The questionnaires (ASQ and so) are standardized to be applied to our country.

Firstly, respondents filled out the questionnaire concerning socio-demographic variables including age, gender, class, place of residence. The impact of social isolation was measured through the Adolescent Stress Questionnaire (ASQ-N),the ASQ consists of a 56-item inventory, reflecting 10 stress dimensions within the last 12-month period: a) the stress of home life, b) school performance, c) school attendance, d) romantic relationships, e) peer pressure, f) teacher interaction, g) future uncertainty, h) school/leisure conflict, i) financial pressure and k) emerging adult responsibility. Participants rate the level of stress experienced on a five-point Liker-type scale (1 = not stressful at all to 5 = very stressful). Scale scores were calculated by summing the affirmed response to each item across all items defining any particular scale, and the total score was produced by the sum of the score from each dimension.

The second questionnaire that was used is The Aggression Questionnaire; (AQ), was developed by Buss and Perry and has a high reliability (Cranbach’s α = 0.86).

The scale consists of 29 items scored and the participants rate the level of stress experienced on a five-point Likert-type scale (1 = not stressful at all to 5 = very stressful). This scale contains four subscales: (a) physical aggression, (b) verbal aggression, (c) anger, and (d) hostility. Possible total scores range from 29 to 145, with higher scores indicating higher levels of aggression.

Organization and Procedure of Research

The research was organized after the exit from social isolation, through an online survey, the measuring instruments were first translated and adapted to the Albanian language, and then they were applied in a period of 2 months. The survey method was online and included the entire territory of Kosovo. In online surveys, the respondents were informed that their participation is free and voluntary and if they change their mind they can withdraw. They were also informed in advance that confidentiality will be maintained. The research has received ethical approval.

Data Analysis

The Statistical Package for Social Sciences (SPSS) version 21 was used for data analysis. First, socio-demographic variables (age, gender, residence) were analysed, and then social isolation was studied, which is related to fear, pandemic stress, lack of social support, self-care, rational coping, and aggressive behavior in teenagers.

Pearson's correlations, according to the normal distribution of the data, were used to test the relationships between the examined variables.

Result

Demographic Profile of Respondents

Table 1, describes the general characteristics of the study participants. Of the 220 participants, of which 115 or (52.3%) were female and 105 of them or (47.7%) were male, while regarding the age of the 220 participants, the age of 13-15 years is represented by 62 (27.7%), the age 16-18 year olds are represented by 85 (38.9%) while 19-21 year olds are represented by 73 (33.5%). Participants came from urban areas 128 (57.8%) and 92 (42.2%) from rural areas. Of the 220 annexed persons, 97 (43.7) were single and 123 (56.3%) were in a relationship.

Table 1: Socio demographic characteristics study participants.

Variables

Categories

N

%

Gender

Male

115

52.3

Female

105

47.7

Age

13-15

62

27.7

16-18

85

38.9

19-21

73

33.5

Residence

Urban

128

57.8

Rural

94

42.2

Social status

Single

97

43.7

In relationship

123

56.3

Table 2: Statistic on level of stress during social isolation.

Variable

N

%

Stress

Normal

58

25.3

Mild

27

11.7

Moderate

91

42.8

High

44

20.2

Total

220

 

Table 2 shows the distribution of participants depending on the level of severity of stress, with lower values indicating lower levels of severity and vice versa. Depending on the values of the severity levels of the stress questionnaire, participants have resulted in these levels of stress. Thus, for stress it is seen that 91 (42.8) adolescent are moderate stress, 58 (25.3%) adolescent have normal stress, 44 (20.2%) adolescent have high stress and 27 (11.7%) adolescent have mild stress.

Table 3: Statistic of the level of general aggressive behavior of adolescent during social isolation.

Variable

N

%

Aggression

Physical aggression

32

14.2

Verbal aggression

94

42.4

Anger

73

33.1

Hostility

21

10.3

Total

220

 

The Buss-Perry Aggression Questionnaire (BP-AQ) is an instrument with 29 items, with four factors that measures physical aggression, verbal aggression, anger and hostility. According to the results, adolescents during social isolation showed higher levels of verbal aggression (42.4 %), followed by anger (33.3 %), followed by physical violence (14.2 %) and hostility (10.3 %).

The following table will present the Spearman correlation analysis. It includes the Spearman Correlation level which indicates the degree of correlation between the respective variables. The level of significance for this result is also presented.

Table 4: Correlation analysis between social isolation, stress and behavioural aggressive.

Spearman’s

 

Social isolation

Stress

Correlation Coefficient

763**

Sig.(2-tailed)

0

N

220

Aggressive Behavioral

Correlation Coefficient

643**

Sig.(2-tailed)

0

N

220

From Spearman's correlation analysis, it can be seen that social isolation and pandemic stress have a significant positive correlation (r = .763; p = 0.00), so with the increase of social isolation from COVID-19, the other variable, in this case stress, will increase. Social isolation and aggressive behavior also have significant positive correlations (r = .643; p = .000), and the more social isolation, the more aggressive behavior will increase. Among all these, stress shows the strongest correlation with social isolation during the pandemic compared to aggressive behavior.

Discussion

The findings from this study confirm that physical distancing, the circumstances created against the spread of COVID-19, social isolation has influenced stress and aggressive behavior in Kosovar teenagers. From the findings of previous studies, through which the multidimensional factors of violence in Kosovo's public schools have been explored, it is reported that violence through the Internet is present among students of grades 6-9 in schools public in Kosovo, including bullying/threatening via internet/telephone (13.8%), gossiping about students via internet/email/Facebook/other social media (10.8%), and threatening/shaming via sharing photos (5.9%).

The findings of the study show that most of the teenagers were affected by social isolation and showed different levels of stress, in this order, average, normal, high and low stress. Another finding of the research was that teenagers were unprepared to face the pandemic and the change in their lives from a free life to social isolation, and this rapid change has resulted in the appearance of aggressive behavior in different forms. According to the results, the most frequency of aggressive behavior was verbal aggression, aggressiveness, physical violence and hostility.

These obtained results can serve as recommendations for state leaders regarding the management of the situation based on the analyses obtained. Also, these results should be taken into account in the creation of programs that aim to help teenagers face different situations during social isolation. The creation of psycho-social services, free psychological consultation lines would help teenagers in different periods of their lives. These services would prevent and reduce fear of Covid-19, and then gradually reduce stress levels and manage aggressive behavior.

Conclusion

In conclusion, this study suggests that social isolation is an important element of quality of life and has a direct link to adolescent health during the pandemic period.

The findings from this study confirm that social isolation, the circumstances created against the spread of COVID-19, including changes in the lives of teenagers, have caused a series of concerns among children and parents in Kosovo. These changes are in line with expectations that the spread of COVID-19 has caused fear, stress, anxiety and other concerns among citizens in various countries around the world. Our study supports these data by verifying that social isolation has influenced adolescents to increase stress and display aggressive behavior in different forms.

Conflict of Interest

The authors declare no conflict of interest.

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