Motivation and emotion/Book/2021/COVID-19 pandemic impacts on emotion

Overview
The focus of this book chapter is to understand how psychological theories of emotion can help explain how the COVID-19 pandemic impacted on human emotions. The COVID-19 preventative measures enacted to slow transmission and protect populations included a total upheaval of daily life. People had to quickly adjust to a new normal; social activities moved online formats, and social distancing, mask-wearing, and quarantine became the new social norm. The COVID-19 pandemic changed how humans communicated and connected with one another, and these changes have significantly impacted the lives and emotions of millions worldwide.

Focus questions:
 * Why do we have emotions and what are the core psychological theories of emotion?
 * Which common emotions has the COVID-19 pandemic evoked, and why?
 * What does psychological research suggests helps us regulate emotions during a pandemic?

What is emotion?
Emotional states occur due to a combination of three components; physiological arousal, psychological assessment, and subjective experiences (Spielman et al., 2014). These components are influenced by background, culture, and personal experiences. Emotions serve an evolutionary function as a rapid system of processes that coordinate an organised response to stimuli through perception, attention, learning, memory, motivational and goal priorities, physiological reactions, and behavioural decision making (Tooby & Cosmides, 2008).

This section explores the main theories of emotions (see Figure 1) which are categorised into three domains:


 * Physiological theories (James-Lange Theory of Emotion, Cannon-Bard Theory of Emotion)
 * Neurological theories (Facial-Feedback Theory of Emotion)
 * Cognitive theories (Schachter-Singer Two-Factor Theory, Cognitive Appraisal Theory)

James-Lange Theory of Emotion
The James-Lange theory of emotion proposes that external stimuli cause the sympathetic nervous system to respond with a physiological response, which causes an individual to have an emotional experience (Cannon, 1927). This theory was popular around its conception but has faced criticism due to the non-discriminatory nature of physiological arousal which does not successfully differentiate individual emotions and arguments that physiological arousal accounts for a small portion of emotional experience (Cannon, 1927).

Cannon-Bard Theory of Emotion
The Cannon-Bard theory of emotion was developed to address valid criticisms of the James-Lange theory (Cannon, 1927). This theory proposes that physiological changes and emotions occur simultaneously and independently, as opposed to one before the other (Dror, 2014). This theory supports neurobiological research which suggests that sensed information is sent to the dorsal thalamus and amygdala simultaneously causing physiological arousal and emotional response.

Facial Feedback Theory of Emotion
The Facial-Feedback theory of emotion hypothesises that facial expressions are critical in the subjective experience of emotion (Söderkvist et al., 2018). This theory is divided into two domains; initiating function which suggests that facial expression can produce an emotional experience without any emotional stimulus, and modulating function, which describes the use of an emotional stimuli to investigate the effect of manipulated facial muscles on subjective emotional experience (Söderkvist et al., 2018).

Two-Factor Theory of Emotion
The two-factor theory of emotion was proposed by Stanley Schachter and Jerome E. Singerand, and incorporates reasoning into emotional processing (Schachter & Singer, 1962). The theory posits that emotional experiences are determined by arousal and cognition. The intensity of arousal, in addition to the cognitive appraisal we connect to the stimulus or situation, will determine what emotion is evoked (Schachter & Singer, 1962).

Cognitive Appraisal Theory
The cognitive appraisal theory of emotion was born out of research by Magda Arnold and Richard Lazarus, who posited that our emotions come from our appraisals of situations (Lazarus, 1982). An individual cognitively appraises a situation, then experiences a physiological and emotional response simultaneously (Lazarus, 1982). This theory differs from physiological and neurological theories as it considers why individuals have different evaluating perceptions and emotional responses when faced with similar situations. Lazarus advanced cognitive appraisal theory by developing the transactional model of stress (see Figure 2.) which utilises cognitive appraisal to argue that stressful experiences are based on an individual’s primary and secondary appraisal of the event (Berjot & Gillet, 2011). Cognitive appraisal theory is most relevant to the COVID-19 pandemic as our emotional response is dependant on how we appraise stressful situations.



Our emotional state occurs because of which three components of emotion?}

- Physiological arousal, sweating, objective experiences - Physical arousal, psychological assessment, objective experiences - Psychiatric assessment, psychological feeling, subjective experiences + Physiological arousal, psychological assessment, subjective experiences
 * type=""}

{Which theory of emotion is characterised by the presentation of a stimulus followed by physiological arousal and emotional response occurring simultaneously and independently?}

+ Cannon-Bard. - Cognitive Appraisal - Schachter-Singer Two-Factor - James-Lange
 * type=""}

Fear and uncertainty


Fear is a basic human emotion that is triggered in response to a perceived threat (Schimmenti et al., 2020). The COVID-19 pandemic triggers fear-based threats across four interconnected domains; bodily, interpersonal, behavioural, and cognitive domains (Schimmenti et al., 2020). Bodily domain refers to “fear of the body” and “fear for the body”, two interrelating concepts whose focus may continuously shift. Fear of the body encapsulates a sense of physical vulnerability, where the body is seen as a potential source of danger which we can no longer trust, whilst fear for the body captures our innate desire for protection and survival (see Figure 3) (Schimmenti et al., 2020). During a pandemic, we could unknowingly be carrying the virus, we are surrounded by individuals who may or may not pose a transmissible threat, and we fear accidentally passing the virus on to loved ones (Schimmenti et al., 2020). This relates to the interpersonal domain which refers to "fear of significant others" and "fear for significant others". The pandemic has changed the way we perceive interpersonal relationships. Transitioning from a source of emotional safety and protection to a potential threat to health, the interpersonal domain encompasses "fear of infection from loved ones" and "fear of infecting loved ones" (Schimmenti et al., 2020). The cognitive domain refers to "fear of not knowing" and "fear of knowing" (Schimmenti et al., 2020). This pertains to the lack of definitive knowledge about the virus, especially early on when little was known about aetiology and treatment. Lack of knowledge creates a sense of uncertainty, and as more was discovered, individuals had to balance the necessity for survival-promoting information versus fear-provoking information and misinformation (Schimmenti et al., 2020). All three previous domains impact behavioural consequences of fear during the pandemic. Fear of behavioural action or inaction can leave individuals paralysed between the innate desire to act when exposed to danger, and fear of doing the wrong thing (Schimmenti et al., 2020). Furthermore, the impact of isolation and protective measures disrupted economic and social systems resulting in additional fears, including:
 * Fear of losing income and accommodation
 * Fear of poverty, debt, and being unable to support self and family
 * Fear of mental health impact
 * Fear of healthcare systems being unable to manage crisis
 * Fear for the future



Which domain of fear is associated with a shift from seeing a loved one as a source of emotional safety to a potential threat to health?}

- Behavioural domain - Cognitive domain - Bodily domain + Interpersonal domain
 * type=""}

Grief and loss
Grief is an emotion characterised as a normal response to traumatic loss and can be triggered immediately following a crisis, or as a delayed, exaggerated, or absent process (Anderson, 2010). The intensity of grief is highly dependent on the nature of the relationship between the person experiencing the emotion, and what is lost. During the COVID-19 pandemic, global populations collectively experienced loss, whether it be loss of a loved one, loss of employment and financial security, loss of celebrating milestones and events, or loss of routine, normalcy, or physical connectedness (Anderson, 2010). Research by Bertucci & Runion (2020), describes three frameworks for loss; ambiguous loss, anticipatory loss, and complicated grief.

Ambiguous loss is characterised by uncertainty and lack of closure and, in the context of the pandemic, can occur when there is psychological presence with physical absence (Bertuccio & Runion, 2020). This loss encapsulates the uncertainty and questioning that many still have about how the pandemic will affect their life. Ambiguous loss is perhaps the most challenging form of loss, due to the degree of uncertainty for the future, and lack of closure. Questioning if, when, and how we will get back to ‘normal’ life takes a psychological toll due to lack of resolution. Anticipatory grief is characterised as dreading future losses. As more information comes to light regarding the future management of COVID-19 in communities, people start to question the if they or their loved ones will inevitably contract the virus and experience significant illness or death. Similarly, people anticipate future losses involving milestones and events such as graduations, weddings, or the birth of children and grandchildren. Complicated grief is characterised as persistent, intense, and consuming, and can occur when there are unchangeable circumstances compounding the loss (Bertuccio & Runion, 2020). The complex nature of the pandemic means that natural rituals associated with grief and mourning were disrupted. Many families are unable to attend funerals to mourn the collective loss or say goodbye. In complicated grief, individuals experience severe and dysfunction symptoms including loneliness, shock, denial, mistrust, anger and rumination, symptoms which mimic anxiety or depression symptomatology, but it differs due to its direct association with loss (Bertuccio & Runion, 2020). 

The following question is indicative of which type of grief/loss: Will life ever go back to how it was before, or is this the beginning of a new normal?}

- Complicated grief - Anticipatory loss + Ambiguous loss - Atypical loss
 * type=""}

Anger and frustration
Anger is a heightened emotional state associated with a strong, non-cooperative emotional response to perceived provocation or threat (Alia-Klein et al., 2020). Anger is a normal emotion for humans to express when faced with a threat and has served as a survival mechanism throughout evolution. Fear and anger are both triggered by threats, however, they differ in their appraisal depending on the attribution to threat source and perceived control (Erhardt et al., 2021). Fear-based responses occur when the source of threat is ambiguous and there is little perceived control, resulting in harm-avoidance behaviours (Erhardt et al., 2021). Anger occurs when there is a source that can be held accountable, resulting in behaviours to attribute blame and remove the source from the environment (Erhardt et al., 2021). Cognitive appraisal theory suggests that anger is highest when individuals have someone to blame, especially if the situation is considered controllable, and actions taken, ineffective (Erhardt et al., 2021). The fear that was felt at the start of the pandemic slowly transitioned to anger when people sought to blame the source of the threat. This resulted in anger centred around xenophobic anti-Chinese rhetoric, and anger and distrust towards government decisions surrounding restrictions of movements, social isolation, preventative measures, and lack of healthcare preparedness and resources (Erhardt et al., 2021; Reny & Barreto, 2020). Anger can fuel fight behaviour and rebellion in the form of protests and rejecting protective measures. Anger and conflict are associated with younger age, low-socioeconomic demographics, ethnic minorities and individuals experiencing significant financial hardship due to enacted COVID-19 measures (Smith et al., 2021).



Cognitive appraisal theory suggests that anger will be highest when...}

- The source of the threat is a lie - Individuals feel overwhelmed - The source of threat is ambiguous + Individuals have someone to blame
 * type=""}

Loneliness
Loneliness is a negative emotion characterised by a perceived discrepancy between desired social interaction and actual social interaction (Dahlberg, 2021). Social interaction incorporates the quality, frequency, and duration of interactions with others (Dahlberg, 2021). The COVID-19 pandemic required vast numbers of the population to physically distance and socially isolate in attempts to minimise the risk of transmission. Loneliness is differentiated from social isolation, which is characterised by living alone, having little or infrequent social interactions and activities (Dahlberg, 2021). Social isolation is a risk factor for experiencing loneliness, and loneliness is correlated to poorer health outcomes, decreased cognitive functioning, lower quality of life, mental health symptomatology, and mortality (Dahlberg, 2021; Pai & Vella, 2021). There appears to be a general impression that the pandemic has had a disproportionate impact on young adults and the elderly, however, a rapid systematic review by Pia & Vella (2021) demonstrated mixed results between country demographics. All 24 studies showed a significant level of loneliness and associated poorer outcomes in adult populations, however, loneliness has been a known significant health issue across countries before the COVID-19 pandemic, and it is unclear if loneliness has increased specifically due to pandemic effects. Mental illness or health and resilience appeared to be more significant risk and protective factors for loneliness over demographic factors, such as age or gender (Pai & Vella, 2021). Nevertheless, the nature of preventative measures and isolation strategies enacted by governments worldwide reduced social interaction, and loneliness is a normal emotional response to this experience. 

Research by Pia & Vella (2021) shows clear evidence that COVID-19 has disproportionally impacted young people. - True + False
 * type=""}

Hopelessness


Hopelessness is defined as negative self-view regarding one’s standing in the world and future and is typified as not having a solution for challenging problems (Franza et al., 2020). Hopelessness occurs when individuals experience a stressful, persistent and unpredictable event, which formulates negative expectations for the future, and a belief that nothing can be done to change the situation (Zuo et al., 2021). Feelings of hopelessness can prompt depressive symptoms, serious mental health problems and suicidal tendencies (Zuo et al., 2021). The COVID-19 pandemics persistent, unpredictable, and stressful nature impacted populations, however, literature regarding hopelessness focuses predominantly on healthcare workers (see Figure 4). Healthcare workers endure stressors including high emotional load, long shifts, exposure to trauma, and perceived obligation to continue work despite detrimental effects (Franza et al., 2020). The pandemic has exacerbated these conditions by increasing perception of risk, the requirement for extensive PPE, potential lack of resources and staff to meet health system needs, and requirement to socially isolate to minimise risk to family, which reduces social support (Franza et al., 2020). Perceived social support and finding meaning in life both serve as protective factors against hopelessness (Zuo et al., 2021).

Resilience and gratitude
Resilience is defined as the capacity to successfully adapt emotional responses in the face of adversity, while maintaining normal psychological functioning (Wu et al., 2013). Gratitude is defined as a propensity towards appreciation for the positives in the world (Biber et al., 2020). Whilst unlikely emotional traits to arise from the COVID-19 pandemic, this period of crisis and confrontation with existential vulnerability has given many people the opportunity to reflect on current life, values, and future plans (Jans-Beken, 2021). Gratitude is shown to be negatively correlated with depression, stress, helplessness, and resilience and gratitude have been found to mitigate maladaptive coping mechanisms and promote healthy emotional functioning, coping mechanisms, and mental health. (Biber et al., 2020; Jans-Beken, 2021; Wu et al., 2013). An Italian study exploring positive and negative pandemic impacts found that positive experiences included “being part of an extraordinary experience” “discovering oneself”, “re-discovering family” and “sharing life at a distance”, while an Australian study found that the most common positive themes to arise from the pandemic included “family time”, “work flexibility’, and a “calmer life” (Cornell et al., 2021; Fioretti et al., 2020).

What does psychological research suggest to regulate emotions during a pandemic?
Cognitive appraisal theory and the transactional model of stress discuss the experience of emotion being impacted by primary and secondary appraisals of a situation. A recent study exploring how to mitigate adverse experiences to the COVID-19 pandemic discusses the use of reappraisal in minimising negative emotions and increasing positive emotions (Wang et al., 2021). Increased levels of negative emotion and reduced levels of positive emotion have been associated with an increased risk of anxiety and depressive disorders, impaired social connections, compromised immune functioning, increased maladaptive eating behaviours, disturbed sleep, impaired learning and worse job performance (Wang et al., 2021). Reappraisal can be utilised as an emotional regulation strategy to modify how one thinks about a certain situation, with the core goal to change one’s emotional experience (Wang et al., 2021). There are two types of reappraisal; reconstrual, which involves changing how a situation was construed or mentally constructed, and repurposing, which involves focussing on a potentially positive outcome that could arise from the current situations in a way that alters the emotional response (Wang et al., 2021).

Reconstrual example: “I know that washing my hands, wearing a mask, keeping socially distanced from people, and getting vaccinated, are easy and safe things that are in my control and protect myself from COVID-19”

Repurposing example: “The COVID-19 pandemic has given me the opportunity to reassess my values, and it helped me understand how important meaningful connections are in my life”

By changing the way we appraise stressful experiences, individuals can reconstruct their emotional responses to focus on the positives in the situation. Meta-analyses have demonstrated that this simple, yet powerful, tool produces reliable effects and can help increase positive emotional experiences and reduce negative emotional experiences (Wang et al., 2021). Research also supports that physical activity, mindfulness, humour, and reducing social media use can assist emotional regulation during a pandemic. (Bernstein & McNally, 2018; Saricali et al., 2020; Shao et al., 2021).

Conclusion
Emotion is an evolutionary process that is influenced by personal experiences, background, and culture, which allows us to respond to environmental stimuli. Core theories of emotion include James-Lange, Cannon-Bard, Facial-Feedback, Two-Factor, and Cognitive Appraisal theories. Cognitive Appraisal Theory is most relevant to the COVID-19 pandemic as an emotional response is dependant on how we appraise a situation. The pandemic is commonly appraised as a threat to safety and normalcy, which can induce feelings of fear and uncertainty, anger and frustration, grief and loss, loneliness, and hopelessness. However, existential threats to normalcy can also allow self-reflection processes that may induce positive emotions, such as resilience and gratitude. Psychological research suggests that physical activity, reducing social media consumption, mindfulness, humour, and reappraisal interventions, can modify the way we experience emotions, producing more effective emotional regulation during stressful events.