DOI: [Link]

53350/pjmhs22165352
ORIGINAL ARTICLE

Covid-19 Pandemic: A Qualitative Study on Adolescents’ Stress, Anxiety,

and Family Communication
ZEYNEP ÇETIN1
1
Faculty of Health Sciences, Department of Child Development, Hacettepe University, Ankara, Turkey; ORCID ID: [Link]
Corresponding author: Zeynep Çetin

ABSTRACT
Eight high-school students participated in this qualitative study to investigate the adolescents’ stress, anxiety, and family
communication during the COVID-19 pandemic. To collect data, a list of questions was prepared by the researchers based on
experts’ opinions, and open-ended interviews were carried out with the participants. Consequently, four models were created
and thoroughly investigated. According to the results, the COVID-19 pandemic led to higher levels of stress and anxiety and
both positive and negative effects in the adolescents’ communication with their families. It seems that the period of social
isolation adversely affected the adolescents’ interaction with their peers.
Keywords: COVID-19; adolescents; stress and anxiety; family communication

INTRODUCTION Adolescence and Family Communication: The role of parents in

The COVID-19 pandemic isolated individuals from their family and an individual’s life is quite substantial in adolescence. Several
friends, posed communication difficulties and thus exposed people studies reported that many stress factors affect adolescents
to behavioral problems mainly caused by the unaccustomed (Goodman et al., 2005; Grour et al., 1992; Sigfusdottir et al., 2017).
conditions of living alone (Brooks et al., 2020). Due to the life- Goodman et al. (2005) stated that stress in the family affects both
threatening nature of the disease, a change in our lifestyle and parenting styles and parent-child relationships. Family
reducing social communication was inevitable to prevent the communication is a key element for the adolescents while growing
spread of the virus (Everett et al., 2020). Considering the fact that into adults. White (1996) reported that adolescents are highly
strong social relationships play a key role in the developmental influenced by family communication in their decision-making
stages of life, it is likely that the pandemic affected teenagers and processes. For this and other similar reasons, family relationships
adolescents. According to Steinberg (2005); Steinberg et al. play an important role in adolescent development (De Los Reyes
(2011), adolescence is the period in which individuals experience et al., 2019).
changes in both emotional and physical characteristics quite The COVID-19 pandemic has caused many social and
intensely. Thus, it is probable that adolescents with such intense psychological changes in everyone's lives, including adolescents
emotions are affected more than adults during the pandemic. (McGinty et al., 2020; Sani et al., 2020; Ünver et al., 2020). In
Together with national legislations, confinement, curfews, particular, families with children faced a great extent of stress due
and quarantine were imposed in most of the countries. Quarantine to losses in their financial resources and psychological support for
is often accompanied by negative emotions that can cause anxiety, their children (Patrick et al., 2020). Considering that these stress
boredom, and/or restlessness (Brooks et al., 2020; Qiu et al., factors affect not only the parents but also the children, it is
2020). Thus, quarantine, together with the stress and anxiety that important to keep the family communication efficient, healthy, and
is generally present in the development process of adolescents, productive to protect the children -and their future life- from
caused stronger emotional distress, stress and anxiety, and undesirable effects of the stress (Brown et al., 2020).
subsequent problems in family communication during the Many studies have been conducted on adolescents during
pandemic (Akoğlu & Karaaslan, 2020). the pandemic (Andrews et al., 2020; Bećirović & Pajević, 2020;
Stress and Anxiety in Adolescents: Although there are many Prime et al., 2020; Wray-Lake et al., 2020). However, the
definitions of stress, it can generally be defined as the biological, communication skills of adolescents during the pandemic are not
physical and mental reaction of the organism to a negative studied in full depth. Thus, the present study titled “COVID-19
situation (Del Giudice et al., 2018; Endler & Parker, 1990; McEwen Pandemic: A Qualitative Study on Adolescents’ Stress, Anxiety
& Karatsoreos, 2020). Anxiety, on the other hand, is defined as a and Family Communication” was planned to fill in the gap in the
state that includes emotional, cognitive and behavioral responses relevant literature.
to an uncertain threat anticipation (Grupe & Nitschke, 2013). Within the scope of this study, we aimed to thoroughly
Johnston (2020) defined stress as feeling overwhelmed due to investigate:
inability to cope with the situation encountered. However, anxiety  How the pandemic affected the stress and anxiety levels of
does not have an identifiable cause and its treatment usually the adolescents?
requires more than just changing the lifestyle. Lazarus (1976)  How the family communication of the adolescents changed
defined anxiety as an emotion within stress. Long-term stress can during the pandemic?
lead to anxiety (Endler & Parker, 1990).  And to determine the most intense emotions of the
Stress experienced during adolescence can cause both adolescents during the pandemic.
anxiety and permanent cognitive deficits (Afifi et al., 2016;
Goodman et al., 2005; Provensi et al., 2019). Troy and Mauss MATERIAL AND METHODS
(2011) stated that stressful life events in adolescence can cause Settings and Participants: The study group consists of 8 high-
mental health deterioration and lead to negative consequences school students in the 2020-2021 academic year. While forming
such as anxiety and depression. Therefore, stressful events during the study group, we used the "maximum diversity sampling"
this period are likely to pose a risk to an individual’s mental health method as one of the purposeful sampling methods used in
during adulthood (Lo Iacono & Carola, 2018). In addition, Basut qualitative research. So, one girl and one boy were selected from
(2006) emphasized the importance of efficient stress-coping ways each class of the high school. The diverse sampling enabled us to
and positive parental role models during adolescence to reduce determine whether there were any common or shared situations.
the risk of tendency to crime and substance abuse later in life. In Research Design: This research was conducted using case study
this context, the communication and interaction between approach as one of the qualitative methods. Creswell (2013)
adolescents and their families is a prominent factor in stress defined qualitative studies as a way to collect and examine non-
management. numerical data in order to narrow a wide research area to an easily
ascertainable topic. Data collection process in qualitative studies

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 Z. Çetin

can be completed in three different ways: (a) in-depth, open-ended I deeply want anyway. I tell my parents what I want, and they buy it
interviews, (b) written documents and (c) direct observation for me. I am also saving a little bit.” Another student said: “For
(Patton, 2014). We used in-depth, open-ended interviews to collect expensive things such as smart phones, I save money. But not for
our data because case studies aim to understand and interpret the clothes and other stuff”. The amount of the pocket money that is
current situation or to examine the problem in depth (Mohajan, given to adolescents should be controlled and sufficient to meet
2018). their needs. It is known that excessive and uncontrolled pocket
Data Collection and Analysis: First, a semi-structured interview money can lead to problems such as substance use (Kumar et al.,
form was created by the researchers and five experts were asked 2014; Mohan et al., 2005; Punitha et al., 2014). Kumsa et al.
for their views and opinions about the questions. The second step (2020) stated that difficulties in receiving pocket money may have
was a pilot study conducted on two adolescents to identify the negative effects on students’ academic success and behaviors
questions that elicited same/similar answers. The pilot study and (Ardiansyah et al., 2017).
expert opinion were deemed appropriate to ensure the validity of Regarding the theme of “Role Distribution”, although there
the obtained data in reflecting the reality, the consistency of the was no distinct set of rules, the adolescents had some
results, and the reliability that indicates the congruity of the data for responsibilities at home. One student said: “There is not much
the purpose of the study. The semi-structured interview form distribution of roles actually.” And another said: “Well I think there
included a total of 11 questions under 3 main themes and also is a distribution of roles at home, but I think the roles assigned to
probing questions. 2 specialists in the field of child development me are a little less than others…”. There was no clear description
were consulted through online interviews or phone calls. Written of the responsibilities given to the adolescents participating in the
consent was obtained from the participants and their families. The study, yet they did not have any difficulty in fulfilling their
interviews lasted an average of 30 minutes. First, the tapescript of responsibilities. “I mean, they are not difficult things…” and “Easy
the interviews was made as a single text document. Then, the data and simple things that take 10-15 minutes” were the answers of
were encoded, themes were identified, the codes were arranged two participants. However, one subject expressed that he needed
according to themes, and the findings were interpreted (Şimşek & to take care of his younger brother, which was exhausting for him:
Yıldırım, 2011). To code the themes, two researchers worked “It is tiring because the age difference between the two of us is so
independently to code the tapescript. Then, they discussed the much that whatever interests me is boring for him, and the other
codes to develop a new coding framework. Each identified theme way around. He always wants to do the same things and I get
was interpreted separately. bored”. When assigning responsibilities to adolescents, it is
We used the MAXQDA software to categorize the interviews important to bear in mind that the assignments should be within the
within the coding framework and applied the 21 steps of Standards capabilities of the adolescents to avoid potential negative effects
for Reporting Qualitative Research (O'Brien et al., 2014) in our on their development. While trying to fulfill the duties and
study. responsibilities expected by their parents, adolescents may have
the false notion that their needs are less important than those of
FINDINGS AND DISCUSSION others. This can cause them to ignore their own needs, interests,
The financial situation and the harmony within the family are two and relationships later in life (Köyden, 2015). Through appropriate
important factors that can affect adolescents. In order to better responsibilities, adolescents acquire self-discipline and learn to
evaluate the family situation of our participants, information about implement it to achieve their goals (Taşdemir & Dağıstan, 2014). It
their families was collected and grouped under two themes as is reported that assigning responsibilities beyond their capabilities
“Role Distribution” and “Family Financial Situation”. The can lead to several problems in adolescents’ lives (Demir et al.,
"Information About Family" is represented in Model 1. 2005).
Examining how the participants spent their time before the
pandemic revealed two main themes, namely time spent at home
(consisting of three sub-themes) and outside home. The model for
adolescents whiling their time before the pandemic is given as
Model 2.

Model 1: Model of the Information About Family

The theme of “Family Financial Situation” included two sub-

themes, namely: daily allowance (pocket money) of the
adolescents and whether they could buy what they wanted to.
During the pandemic, not all of the participants received their
pocket money, as one said: “I don’t get any pocket money during
the pandemic; even if I do, I can’t do anything with it.” It was not
only during the pandemic; most of them were not getting pocket Model 2: Adolescents' time structuring model before the pandemic
money from their parents before the pandemic. One student said: Before the pandemic, our participants usually spent their out-
“It is not on a weekly or monthly basis. You know, it is not really of-home time with their friends and in the school. One of the
regular.” Yet, none of the subjects had trouble buying what they participants said: “Before the confinement, I usually walked around
wanted to. One student said: “You know, lately there isn’t anything the beach with my friends. We used to go to shopping malls.”
Another one said: “I used to wake up early at about 7-7.30, I used

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Covid-19 Pandemic: A Qualitative Study on Adolescents’ Stress, Anxiety, and Family Communication

to be at school from 8 to 15:30. After school, sometimes I would Spending high-quality and effective time outside their room with
meet with my friends and go for a walk, sometimes I would visit my their parents is effective in the well-being of adolescents.
aunts, sometimes I would come home and study depending on the Regarding the most adverse impacts of the pandemic on
schedule of my next day, but generally I used to have an active adolescents, we observed two main themes and five sub-themes.
day”. When in contact with their peers, adolescents can better The model for the effects of the pandemic is given in Model 3.
express themselves and through helping, sharing and spending Our participants stated that during the confinement, most of
time with their friends, they get a better understanding of their their days were monotone, routinized, and quite boring as one
personality and values. Thus, peer relationships have an important said: “It’s generally boring and I get tired of doing nothing. I’m
place in adolescence (De Water et al., 2017; Roach, 2019; Van always trying to find something to do, but I can’t”. It is reported that
Harmelen et al., 2020). However, the COVID-19 crisis has posed most of the students find online classes boring (Livana et al., 2020;
restrictions in social communications and adversely affected the Tanu Wijaya, 2020). This gets more pronounced considering the
interaction between friends (Rogers et al., 2021). fact that the students were forced to stay home due to the
Owing to their developmental age, adolescents have a pandemic.
strong tendency to social communication and interaction outside When asked about the negative impacts of the pandemic,
the home rather than spending time at home. Blakemore and Mills our participants mentioned family-related, friends-related, and
(2014) stated that adolescence is an important period in social school-related effects. As a family-related effect, the pandemic had
interaction. One of our participants said: “Before the pandemic, we caused changes in the communication of the adolescents with their
didn’t spend so much time at home, and I am sure you didn’t families. One of the participants said: “Of course my relationship
either”. 3 different sub-themes were identified regarding the time with my family was affected the most. We had arguments and
they were homebound due to the pandemic: the time they spend in quarrels. I don’t know, my mom was always cleaning the house or
their room, the way they spent their time in their room, and the time something, she was always going into my room, she was bothering
they spend outside their room. Our participants spent most of their me, but that’s all. My relationship with my dad was good, we hadn’t
time -around 8-9 hours a day- in their rooms dealing with either seen each other in a long time, we missed each other. I had no
technological devices or studies. One of the participants said: “In problems with my dad”. According to our participants, there was an
my room, I actually do everything, you know, I read books, listen to increase in cleaning behaviors. Rundle et al. (2020); and Signorelli
music, and mostly study. In summers, I don’t even want to leave and Fara (2020) stated that, the COVID-19 pandemic caused a
my room to relax, sometimes I sleep in my room, in my bed, and rise in hygiene awareness and importance. An increase in
then I get up”. Another one said: “I have a TV in my room so I can obsessive cleaning behaviors due to the COVID-19 pandemic are
play video games or watch movies. I spend time lying in my bed reported in the literature (Fernández et al., 2020; Kurt-Demirbaş &
until sleep time”. Parents play a major role in managing the leisure Sevgili-Koçak, 2020). Although the COVID-19 pandemic is an
time activities of adolescents (Hutchinson et al., 2003). It is external stressor outside the family system, given the vagueness
reported that when adolescents are alone, they engage more in of the situation, it is likely to be perceived as a major stressor for
watching TV and other media more than when they are with their many parents and children (Brown et al., 2020). On the other hand,
peers (Larson, 1995). the children started to spend more time with their parents due to
the crisis, which helped them realize more about the character,
temper, and nature of their family members. For instance, one
participant said: “It happened, of course, because we stayed at
home all the time, we got closer and spent time together for almost
three or four months. I think I learned more about my father that I
didn't know before. As we spent more time together, we became
closer”. Another participant said: “I realized that my family
members had habits that I had never noticed before”. It seemed
that the adolescents and their families did not have close-knit
relationships before the pandemic. Home quarantine -as a
preventive measure against the spread of the COVID-19 disease-
brought parents and children together at homes as one participant
said: “Spending so much time with my family was a big change for
me, and we have been so close and together that we had never
been before”. The pandemic had a positive impact on family
communications, which positively contribute to the overall family
atmosphere (Noller & Bagi, 1985).
Friendships enable adolescents learn how to overcome
difficulties, control their behaviors, and approach the opposite sex
(Şahin & Özçelik, 2016). The circle of friends, which has a
Model 3: Model of the effects of the pandemic on adolescents significant impact on the social development of the adolescents
(Bayhan & Işıtan, 2010; Kim & Chun, 2018), was tightened due to
When asked about the time they spent out of their room, one the pandemic. “What affected me the most was that I could no
participant said: “I only go to the kitchen to have a meal, except longer meet my close friends and buddies. We used to meet very
that I go to the living room where I watch TV series with my mother often, learn a lot from each other, and basically grow up together. I
or something”. Another one said: “Generally, I don’t spend much mean, we could not get together anymore, and I felt sad. It truly
time in my room during the day, other than sleeping. Mostly, I am affected me”, said one participant. Likewise, replacing on-campus
in the living room studying”. It seemed that the adolescents did not classes with online lectures created a distance between friends.
engage in common activities with their parents other than daily Feeling very pleased with the possibility of the reopening of
routines. Alt (2015) stated that parenting practices such as parent- schools, one participant said: “We could not go to school. Now I
child communication have a great impact on the well-being of really want to go back to school, even more than before. Actually, I
children and adolescents. According to Alt and Boniel-Nissim heard that schools would be open soon, and the exams would be
(2018), adolescents may exhibit problematic behaviors if family face-to-face. I am so excited”. Attending school from early
communication is inefficient. Therefore, spending too much time in childhood helps children develop both communication and
their room by themselves can increase the risk of breaking away academic skills. Our participants expressed their concern, anxiety
from their families or exhibiting problematic behaviors in the future. and stress regarding their academic success. One of them said:

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 Z. Çetin

“What affected me the most was the anxiety about the university days, I feel down and sad, especially if I have an exam. It is very
entrance exam. I think it is somewhat more difficult now that the different, so I cannot say I am always happy or sad, my feelings
lectures are online, I personally prefer on-campus classes and now are constantly fluctuating. I cry at home because of lockdown”. It is
I am anxious about the future”. Another student expressed his known that infectious diseases have negative effects on the mental
concern as: “I have this anxiety about my studies, and I think and psychological well-being of individuals (Restubog et al., 2020).
online teaching makes it more difficult for me to fully understand While the COVID-19 crisis brought about many changes, social
the lessons. You know, that’s how online lectures make me isolation was the most pronounced one among all. One participant
anxious”. said: “It is a big change. I cannot spend time with my friends
Nevertheless, some studies have reported positive effects of anymore. I started to study more as I am constantly at home”.
the pandemic (Kamdi & Deogade, 2020; Sandín et al., 2020). Brooks et al. (2020) stated that social distancing might lead to
Likewise, our subjects also stated that the pandemic had some individual difficulties, as friends and relatives can no longer visit
positive effects such as: “I started doing sports at home during the each other, and physical contact should be avoided.
pandemic, which is a good thing. I studied a lot more” and Regarding the strongest emotions that the adolescents
“Although sometimes I got tired of constantly being with my family, experienced, we identified sub-dimensions, namely anxiety and
there were times when I started shared things that I didn’t share impatience. Social interactions with peers play an important role in
before. After all, we were together all the time, so we had to have a the psychosocial adaptation of adolescents (Tillfors et al., 2012).
conversation, and I felt like we were getting closer”. Despite the As social interaction decreased to a minimum due to the
fact that spending the whole confinement period at home with pandemic, the adolescents had elevated levels of anxiety and
family members could be boring at times, our participants seemed stress. One participant said: “... seriously, when my close friends
to recognize its positive aspects. and relatives were diagnosed with COVID-19, I realized how
We investigated the areas in which our participants serious it was, and then I felt worried and scared”. Another one
experienced the most changes. The model regarding the changes said: “First I thought that my stress was due to the burden of
experienced during the pandemic is given as Model 4. lessons, exams, and homework. But then I realized that even when
I was studying well, I had the same feelings [stress, anxiety]”. Our
participants reported that during the pandemic they were petulant
and short-tempered. Lee (2020) stated that as a result of COVID-
19, it is predicted that children and adolescents may experience
anxiety, depression and/or stress-related symptoms due to
unprecedented disruptions in their daily lives. Therefore,
adolescents are quite likely to experience higher levels of stress.
Two of our participants responded as: “These feelings [stress and
anxiety] were the most intense when people below 20 years of age
were prohibited from leaving their homes. It was overwhelming
when there was a long period that I could not go out at all” and “I
mean, I was really overwhelmed when we could not leave the
house for 3 months. Now that we can go out on weekdays (though
not on weekends) I feel a lot better. But when we stayed at home
for 3 full months, I was experiencing these [stress and anxiety] to a
great extend”. It is known that the COVID-19 crisis caused an
increase in stress and anxiety levels due to prolonged social
isolation (Pakpour & Griffiths, 2020; Satici et al., 2020).

Model 4: Model of change in adolescents in the pandemic CONCLUSION

Within the scope of the research, four main themes were created:
The changes caused by the pandemic comprised two main information about family, life before the pandemic, the effects of
themes and 7 sub-themes. Some of the participants stated that the pandemic, and changes and emotions. Based on these main
there was an increase in their inner thinking during the pandemic themes, the results are as following:
as one said: “I have a lot of time to spend by myself. I am alone The theme of “Family Financial Situation” was divided into
more than before. For some reason I started writing more and two sub-themes: pocket money of the adolescents and whether
more. I started thinking about myself and the pandemic. I started they could buy what they wanted to. Both before and during the
thinking about my friends”. Another one said: “I have a strange pandemic, the adolescents did not get pocket money on a regular
feeling of being overwhelmed, as if everything is coming on top of basis, so they were dependent on their parents for buying things.
each other. I feel like crying for no good reason. This feeling is so This prevented them from extravagancy. Having financial
intense that I can’t be happy at all”. It seemed that they had more difficulties during adolescence can affect individuals’ self-esteem
“self-talk” during the pandemic. However, prolonged loneliness and and withdraw them from sharing the same environment with their
negative self-talk can lead to inefficient or problematic friends.
communication between individuals. Moreover, mental health is Within the theme of “Role Distribution”, we observed that the
likely to be negatively affected as a result of the decrease in adolescents were given responsibilities within the family. However,
interactions between people due to the pandemic (Orben et al., lack of a specific set of rules caused the responsibilities seem
2020). meaningless for the adolescents. The responsibilities that are
It seemed that the pandemic caused an increase in self- assigned to young adults should be meaningful, practical, and
awareness among the adolescents, which can be due to an within their capabilities. It is also important to bear in mind that
increase in inner thinking. “I mean, I think I grew into a mature assigning too much or too little responsibilities are harmful for
person in this period. I feel it so vividly” said one participant. There young adults in their future lives.
is a positive relationship between adolescents’ self-awareness and Within the theme of “Before the pandemic”, we observed that
their social skills, capabilities, and academic skills (Karamad et al., our participants generally spent most of their time outside the
2020; Turan & İskender, 2020). However, our participants also home usually with their friends and in the school. While at home,
mentioned about the negative changes in their emotions as one they were mostly in their rooms. During adolescence, social
said: “Well, I have contrast emotions in one moment. It is strange. interactions are mostly based on the concept of relations with
Some days, I get up fresh and happy, and spend a nice day. Other friends and peers. In other words, communication with friends is

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Covid-19 Pandemic: A Qualitative Study on Adolescents’ Stress, Anxiety, and Family Communication

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