Problematic Alcohol Use During Quarantine: the Effect of Cognitive Reappraisal
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Bachelor Thesis Clinical Track
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Vrij Universiteit Amsterdam
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Abstract
Emergence of COVID-19 caused many to be subjected to restrictions such as quarantine. Reported
alcohol use during quarantine is higher compared to before, however, protective factors for
problematic alcohol consumption in quarantine are insufficiently studied. This study examines the
association between quarantined individuals and their problematic alcohol use. In addition, we
investigate how an emotion regulation strategy, cognitive reappraisal, moderates the association
between quarantine and alcohol use. Data was collected by survey from 3533 participants aged 18
to 50 years. The Alcohol Use Disorder Identification test and the Emotion Regulation Questionnaire
respectively measured problematic alcohol use and cognitive reappraisal. Results from multiple
regression analyses presented no association between individuals in quarantine and higher levels of
problematic alcohol use. Contrarily, higher levels of cognitive reappraisal associated with less
problematic alcohol use. These findings confirm the transdiagnostic function of cognitive
reappraisal, nevertheless, further investigation and understanding of the effect of quarantine on
substance abuse is necessary.
Introduction
COVID-19 is an infectious disease caused by a virus that can potentially lead to severe
pneumonia and death in certain people (Oxford English Dictionary., 2020). At the beginning of
2020, it was declared a global pandemic by the WHO (WHO, 2021). To prevent rapid spread,
excess mortality, and to preserve hospital capacity, public health restrictions were mandated by the
government to counter the spread of the virus. These restrictions included sanitary guidelines, social
isolation, quarantine, social distancing, closure of non-essential businesses and curfews.
Social distancing measures, aimed to maintain distance and decrease close contact with
other people as well as direct people to self-isolate when infected, were instated to prevent disease
spread. Self isolation and quarantine share the same connotation in practice; they each entail
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separating loved ones and affect routines and activities (Jassim et al., 2021). Despite this, they have
different meanings. Self isolation is mandated in case of infection, and are subsequently separated
from other non-infected individuals (Quarantine and Isolation, 2021). Quarantine however,
separates people who are not ill but have possibly been exposed to the disease (Quarantine and
Isolation, 2021). Individuals’ daily lives and society as a whole were greatly affected by these
measures, notably on general well being and mental health (Fancourt et al., 2020).
Consequences of self-isolation and quarantine measures have both been associated with
psychological problems such as depression, anxiety, PTSD, substance abuse, suicide, self-harm,
anger, acute loneliness and insomnia (Huang & Zao, 2020; Brooks et al., 2020; Holmes et al.,
2020). Individuals who were self isolated experienced higher levels of depression and distress
compared to individuals in quarantine (Jassim et al., 2021). Rates of anxiety were highest at the
early stages of the pandemic (Santabárbara et al., 2021) whilst later in the pandemic higher rates of
depression (Santabárbara et al., 2021) and substance abuse (Volkow & Blanco, 2021) were reported.
While it could be that anxiety increased due to sudden social isolation and fear spread through
media, more research is needed to confirm the working mechanisms behind the increase. In sum,
social isolation, experienced by both self isolated and quarantined individuals, was associated with
higher rates of substance abuse and psychological problems.
It was proposed that the main reasons for increased substance abuse during the pandemic
were boredom, social isolation, change in daily structure, loneliness and conviviality
(Vanderbruggen., 2020; Volkow & Blanco, 2021). Specifically, alcohol consumption rates were
higher during social isolation (Vanderbruggen, 2020), whereby one in six individuals in the UK
reported an increase in alcohol consumption during the COVID 19 lockdown (Louis Jacob et al.,
2021). According to Taylor, et al. (2021), this increase was associated with COVID disregard and
COVID stress. Higher rates in COVID disregard or COVID stress was linked to higher rates of