The psychological effects of confinement
The act of confinement is commonly defined as a situation in which a person is required to stay in a delimited space during a certain amount of time. Although this concept is usually used in criminology to denominate the solitary confinement, it has recently gained special relevance due to the COVID-19 outbreak at the beginning of 2020.
There are different types of confinement, among which we can find:
- Partum confinement – an archaic term – referring to the condition where a woman is in the process of childbirth.
- Civil confinement regarding the isolation of psychiatric patients.
- Solitary confinement as a form of imprisonment where an inmate is kept in a single cell with little or no meaningful contact with other inmates.
- Epidemic confinement as a major mass measure implemented during pandemics such as SARS, Ebola, H1N1 Influenza and COVID-19.
There are multiple studies that analyse the psychological impacts of the solitary confinement. Nonetheless, regarding the COVID-19 global crisis and the self-isolation measures that have been recently taken in order to mitigate such situation, this type of confinement could have psychological consequences that are still unexplored.
Some studies have tried to address the psychological impact of quarantined patients during the SARS (Severe acute respiratory syndrome) outbreak in China and Canada during 2004. By evaluating 129 out of 15,000 diagnosed people in Canada, these studies found evidence of a prevalent psychological distress ranging from 28.9 % to 31.8%.[1]. Symptoms of PTSD (post-traumatic stress disorder) and depression were the main emotional consequences identified, being directly linked with the duration of the quarantine. Even though other factors such as civil status, age, level of education, income and number of children were also addressed, no evidence was found to determine the correlation between those and the appearance or increase of psychological distress symptoms. However, it should be considered that this study recognises having severe limitations due to the low number of analysed subjects and the insufficient scales that it offers for confirming such diagnoses.
On the 11th March 2020, the WHO (World Health Organisation) declared COVID-19 as a pandemic. Following that event, some European countries such as Italy and Spain implemented, for the first time in history, a quasi total confinement among their populations. Due to such unexpected event, many experts are confronting several complexities in terms of evaluating the future impacts that this indefinite quarantine will have on the entire population. Even though data is currently limited, several specialists from the Department of Psychological Medicine in King’s College London have already addressed some of the psychological impacts that the current confinement is having on individuals. According to them, most reviewed studies have reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger [2]. Among the factors that contribute to the appearance of stress, they found that longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma composed a major part of it.
However, even though these may encompass most of the common psychological consequences, the exceptionality of the current situation is already provoking other impacts that have not been previously assessed. Following Spain and Italy’s internal quarantine policies, citizens and mass media have reported the long-term psychological effects that the increasing number of deaths and the funeral deprivation will have on many families[3]. The impossibility of performing the funeral rite together with the imposed measures that require avoiding physical contact at all costs, this exceptional situation will irrevocably lead to psychological consequences never before evaluated. In addition, another of the phenomena that is presently continuing to feed a generalized distress is the anxiety and tension caused by the so-called 'balcony police'.
Far from being an unusual event, this 'balcony police' represents in its sheer essentials, the public lynching that used to be practiced in Europe not that long ago. Due to the general self-isolation that has been imposed, more people are increasingly feeling the anxiety effects produced by the quasi total limitation of movement. As a consequence, many active workers such as sanitaries or cashiers have reported on these last days, the diverse abusive encounters they have experienced from citizens watching and aggressing them from their windows and balconies[4]
This behaviour has indeed been identified as an ‘altruistic punishment’ where now that the community identity seems to be strongly awake, citizens tend to stigmatise individuals that they identify as uncivic entities who betray the collective feeling [5]. In addition, some studies [6] have demonstrated that this public punishment is also performed as a way to improve one's reputation, even in ambiguous situations where punishment may not be deserved. The feeling of being morally superior to the other and to be in possession of the truth, helps people to deal with anxiety and improve their self-esteem even if it is produced in a vicarious way. This behavioural approach has demonstrated to generate an increased activity in the brain’s pleasure centers [7],with the maintenance of 'social order' being the reward. Altruistic punishment thus acts as the 'glue that sticks societies together' where visibility is a trap, as Foucault wrote in his work Discipline and Punish.
References
- ↑ Hawryluck, Laura; Gold, Wayne L.; Robinson, Susan; Pogorski, Stephen; Galea, Sandro; Styra, Rima (July 2004). "SARS Control and Psychological Effects of Quarantine, Toronto, Canada". Emerging Infectious Diseases. 10 (7): 1206–1212. doi:10.3201/eid1007.030703. ISSN 1080-6040. PMC 3323345. PMID 15324539.
- ↑ Brooks, Samantha K.; Webster, Rebecca K.; Smith, Louise E.; Woodland, Lisa; Wessely, Simon; Greenberg, Neil; Rubin, Gideon James (2020-03-14). "The psychological impact of quarantine and how to reduce it: rapid review of the evidence". The Lancet. 395 (10227): 912–920. doi:10.1016/S0140-6736(20)30460-8. ISSN 0140-6736. PMC 7158942 Check
|pmc=value (help). PMID 32112714 Check|pmid=value (help). - ↑ Barroso, F. Javier (2020-03-23). "Madrid utiliza ya como morgue las instalaciones del Palacio de Hielo". EL PAÍS (in español). Retrieved 2020-03-28.
- ↑ Mahtani, Noor (2020-03-26). "Los "policías de balcón" que insultan a discapacitados y sanitarios por estar en la calle". EL PAÍS (in español). Retrieved 2020-03-28.
- ↑ Salas, Javier (2020-03-27). "El peligroso placer de insultar desde los balcones". EL PAÍS (in español). Retrieved 2020-03-28.
- ↑ Jordan, Jillian; Kteily, Nour (2020-03-21). "Punitive but discriminating: Reputation fuels ambiguously-deserved punishment but also sensitivity to moral nuance". doi:10.31234/osf.io/97nhj.
- ↑ de Quervain, Dominique J.-F.; Fischbacher, Urs; Treyer, Valerie; Schellhammer, Melanie; Schnyder, Ulrich; Buck, Alfred; Fehr, Ernst (2004-08-27). "The neural basis of altruistic punishment". Science. 305 (5688): 1254–1258. Bibcode:2004Sci...305.1254D. doi:10.1126/science.1100735. ISSN 1095-9203. PMID 15333831.
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