Chapter II

REVIEW OF RELATED LITERATURE AND STUDIES

In this chapter, associated literatures and related research studies are presented.

The following are the related literature that were collected by the researcher to have

adequate knowledge regarding the study.

Related Literature

Anxiety

Anxiety is the body’s natural response to stress. It is a feeling of fear or

apprehension about what’s to come. Anxiety disorders are the most common form of

emotional disorder and can affect anyone at any age. Stress and anxiety always come

together. Stress is caused by demands placed on your brain or body. An event or activity

that makes you scared or worried can trigger it. Worry, fear, or unease are all symptoms

of anxiety. Anxiety can be a reaction to stress, but it can also strike people who aren't

experiencing any external pressures.

According to the American Psychiatric Association, women are more likely than

men to be diagnosed with an anxiety disorder. (APA, 2021) An anxiety attack can take a

long time to grow for many people. When a stressful situation approaches, it can get

worse. It may also manifest in a variety of ways, and symptoms can differ from person to

person.

Anxiety can be both beneficial and detrimental, depending on its severity and

length, as well as how well an individual manages it. Anxiety has four levels: mild,

moderate, severe, and panic. Each level causes both physiological and emotional changes

in person. (Videbeck, 2017)

Mild anxiety is the sensation that something is out of ordinary and needs extra

care. Sensory stimulation improves concentration and helps an individual learn, solve

problems, think, act, feel, and protect himself. People with mild anxiety are more likely

to make improvements or participate in goal-oriented tasks. (Videbeck, 2017)

Moderate anxiety is characterized by the alarming sense that something is

seriously wrong; the individual becomes anxious or angry. The individual has trouble

focusing on their own, but can be diverted to the subject. (Videbeck, 2017)

As the person progresses to severe anxiety and panic, more primitive survival

skills take over, defensive responses arise, and cognitive skills drops significantly. A

person with severe anxiety has difficulty in thinking and reasoning. In panic-

psychomotor domains dominates with accompanying fight, flight, or freeze responses.

Adrenaline rushes significantly that causes increase in vital signs. (Videbeck, 2017)

According to Salari et al. (2020), his journal focused on articles that have studied

on stress and anxiety prevalence among the general population during the COVID-19

pandemic. Articles were searched in the Science Direct, Embase, Scopus, PubMed, Web

of Science (ISI) and Google Scholar databases, without a lower time limit and until May

2020. The heterogeneity of research was explored using the I2 index, and a meta-analysis

of the gathered papers was performed using the random effects model. Furthermore, the

Comprehensive Meta-Analysis (CMA) software was used to analyze the data. The

prevalence of stress was found to be 29.6% in 5 of the studies with a total sample size of

9074. The Depression, Anxiety, and Stress Scale (DASS-21) is used to assess the results

of the five studies. The prevalence of anxiety was found to be 31.9 percent in 17 research

with a total sample size of 63,439 people.

Social Media

Social media refers to websites and applications that are designed to allow people

to share content quickly. This can be accessed through smartphone apps and via computer

that uses internet connection. It also refers to any internet communication tool that allows

users to broadly share content and take part with the public.

What distinguishes social media from other forms of communication is its breadth

and relative lack of censorship. While many social media companies impose some

restrictions—for example, removing images of violence or nudity—there are far fewer

restrictions on what people can share than there are with other forms of mass

communication such as newspapers, radio stations, and television stations. (Hudson,

2020)

"Feeds," which allow users to skim through content on social media, are often

used. The information that appears and the order in which it appears are determined by

social media businesses using algorithms based on a user's profile data. The stream will

include content from both followed users and people that pay to have their work

promoted. (Hudson, 2020)

According to Sandpiper Communications, which surveyed 1,226 Generation Z’s

across Asia Pacific – covering Australia, China, Hong Kong and Singapore, those who

say social media has been helpful, the majority (69%) say this is because it allows them

to connect with friends and family; and 66% say it has also acted as a distraction and a

useful tool to pass the time: 66% mentioned increased boredom as a problem during the

crisis. For those who have a positive attitude towards social media, 59% say it is a source

of news for them. Yet, the stream of news and information has also become unhealthy.
 15

61% of people say the volume of negative news on social media has had a detrimental

influence on their lives during the pandemic. And, despite their dissatisfaction with the

situation, 38% said social media has made them feel compelled to be always occupied.

(WARC, 2020)

Community Quarantine

The severe contagious nature of COVID-19 has directed to an unhealthy situation

across the world. According to Population Reference Bureau, the worldwide population

is 7.8 billion (PRB, 2020), and approximately 3.9 billion people, had been under

lockdown and quarantined in their respective homes. (Meo et al., 2020) The lockdown

and quarantine polices have been implemented by many countries in order to minimize

the spread of the disease and contain it. The lockdown includes isolation at homes, travel

restrictions, closure of schools, and termination of all public events. Lockdown strategies

nowadays have been enforced all over the world in order to prevent the virus from

spreading even further.

The Philippines was placed under lockdown on March 16, 2020. The entire

archipelago was placed under Enhanced Community Quarantine that lasted for several

months. (Official Gazette, 2020) Curfew and checkpoints were implemented so with

travel restrictions and closure of public buildings. Inter-Agency Task Force for the

COVID-19 pandemic given the authority to provide policies for the community

quarantine.

In a study by Tee et al. (2020), a total of 1879 completed online surveys were

gathered from March 28-April 12, 2020 to investigate the psychological impact of

COVID-19 pandemic in the Philippines. He determined that one-fourth of respondents in

the Philippines had moderate-to-severe anxiety and one-sixth reported moderate-to-

severe depression and psychological effects during the early stages of the epidemic.

In their study of students' social networks and mental health before and after the

COVID-19 crisis in Switzerland, Elmer et al. (2020) found that students' levels of stress,

anxiety, loneliness, and depressive symptoms worsened when compared to measures

taken before the crisis. Fears about missing out on social activities gave way to concerns

for their health, family, friends, and future. COVID-19 particular anxieties, isolation in

social networks, lack of contact and emotional support, and physical isolation were all

linked to poor mental health in exploratory investigations. When differing levels of social

integration and COVID-19 associated stresses were controlled for, female students

appeared to have lower mental health trajectories. The results indicate the importance of

considering counselling in students’ mental health and provide approaches to identify and

support students at higher risk of social isolation and negative psychological effects

during the COVID-19 crisis.

According to a study that examines the impact of lockdown on internet use in

adolescents, comparing their habits from before the pandemic, adolescents from a variety

of nations (including India, Malaysia, Mexico, and the United Kingdom) answered online

surveys that were circulated through social media and youth networks. Questions about

the internet, social media, gaming, sadness, loneliness, diversion, and COVID-19 were

among the metrics used. Adolescents have expanded their use of social networking sites

and streaming services, according to the findings. Furthermore, people with high ratings

on gaming addiction, compulsive internet use, and social media use also had high scores
 17

on sadness, loneliness, diversion, poor sleep quality, and anxiety related to the pandemic.

(Fernandes, 2020)

Regardless of country of residence, the COVID-19 outbreak gave a significant

effect on adolescent internet use and psychosocial well-being. There is a necessity to

address pandemic related distress in order to reduce the effect of maladaptive coping.

Related Studies

One study also examined the relationship between social media use, media

literacy, and anxiety in first-year college students. A sample of (n = 82) first-year college

students was surveyed to study these variables. Results showed a significant relationship

between social media use and anxiety as well as between social media use and media

literacy. However, there was no significant relationship found between media literacy and

anxiety. (Dalpiaz, 2020)

Islam et al. (2020) conducted a study with 476 university students living in

Bangladesh using a cross-sectional web-based survey. Using Google Forms, a

standardized e-questionnaire was created. The data was broken down into three levels of

analysis: univariate, bivariate, and multivariate analysis. Depression and anxiety were at

an all-time high among the students. According to the findings, 392 (82.4 percent)

students experience mild to severe depressive symptoms, while 389 (87.7%) students

have medium to severe anxiety symptoms.

Khoshaim et al. (2020) focused on the anxiety level of university students in

Saudi Arabia during the COVID-19 pandemic. The research took place between March

and June 2020. 400 completed questionnaires were returned after an online survey was

administered. The Zung self-rating anxiety scale was used to determine the respondents'
 18

anxiety levels in this study. According to the findings, approximately 35 percent of the

pupils had moderate to severe anxiety. Anxiety was strongly linked to age, gender, and

educational attainment. These findings can help government agencies and policymakers

understand how critical it is to make quick, effective actions to alleviate students' worry

during the COVID-19 pandemic.