Family Conflict and Mental Health in the Largest Outbreak Areas during COVID-19

Background and Purpose

Family cohesion and ties have been reported as predictors of health and wellbeing (Yoon & Cummings, 2019). Compared to individualism, South Koreans’ collectivist values may have greater impact on family cohesion and ties (Yoon & Choi, 2022). However, during the COVID pandemic, stay-at-home orders, caregiving burden, employment insecurity, and challenging health exacerbated family conflicts (Yoon & Mahapatra, 2024). Social distancing measures were strictly required in some areas but were even stricter in seriously impacted areas during the pandemic in South Korea (Chang et al., 2020; Kim et al., 2023). Strict social distancing measures led to increased family conflicts and even violence against both children and adults (Chang et al., 2020). Family conflicts resulted in heightened loneliness and anxiety (Yoon & Choi, 2022). However, resilience has been reported as a direct and indirect protective factor against negative mental health outcomes such as loneliness, anxiety and depression, even in the middle of challenging situations (Choi et al., 2021). Nevertheless, rare research has investigated family conflicts, mental health, and protective factors in the largest outbreak areas in South Korea during the pandemic. Therefore, this study investigated the impact of family conflicts on mental health among adults in the largest outbreak areas in South Korea during COVID-19 and examined resilience as a protective factor.

Methods

Data were collected from 1,000 adults (ages 19-76) living in areas that were greatly impacted by COVID-19 in South Korea from July to August 2020. The independent variable, family conflict (α=.845), was measured using five items from the Brief Family Relationship Scale (Ting Fok., 2014). The dependent variable, anxiety (α = .922), was measured by GAD-7 (Spitzer et al., 2006). An intervening variable, resilience (α=.832), was measured using the Brief Resilience Scale (Smith et al., 2008), and loneliness (α = .858) was measured by three items by Hughes et al (Hughes et al., 2004). Covariates were physical health, annual income, age, and marital status. Maximum likelihood estimation was employed to impute missing values using SPSS 26 (Enders, 2010). For data analysis, serial multiple mediation analysis was conducted using SPSS PROCESS macro. For indirect effects, 95% confidence intervals were estimated using bootstrapping (5,000 samples).

Results

For direct effects, family conflict was positively associated with loneliness, but negatively associated with resilience. Loneliness was negatively associated with resilience, but positively associated with anxiety. Family conflict was positively associated with anxiety, but resilience was negatively associated with anxiety. For indirect effects, family conflict was associated with anxiety through loneliness, and resilience sequentially.

Conclusion and Implications

Family conflict in the largest outbreak areas in South Korea during the pandemic was significantly associated with negative mental health directly and indirectly. Family conflict increased loneliness and anxiety. However, resilience acted as a vital protective factor against negative mental health outcomes directly and indirectly. Efforts offering appropriate programs and services to increase protective factors such as family support, cohesion, and resilience may help reduce negative mental health outcomes associated with health crises such as COVID-19.