178 Chapter 6 In addition, qualitative data supported our quantitative data. Neutral themes emerged, revealing that forensic outpatients experienced no changes in social relationships due to COVID-19 restrictions, as social isolation and avoidant attitudes towards others were already present before the COVID-19 restrictions. Furthermore, negative changes on social relationships were related to multiple areas of social life, in particular a deterioration of social contacts, interruption of daytime activities, and changed mental healthcare and wellbeing. These areas of change also appeared in previous COVID-19-studies on other psychiatric populations (Chaimowitz et al., 2021; de Cauwer et al., 2020; Kølbæk et al., 2021; Kraaij-Dirkzwager et al., 2021; Sheridan Rains et al., 2021). Lastly, we found that emotional loneliness, but not social loneliness, predicted more adverse changes in general social relationships and romantic relationships of forensic outpatients due to COVID-19 restrictions. These findings are in line with our expectations as well as previous research that distinguished between social and emotional loneliness (Weiss, 1973). Social loneliness refers to a lack of belonging to a certain group (e.g., friends, acquaintances) or a community, while emotional loneliness refers to a lack of attachment with other individuals (DiTommaso & Spinner, 1997). Emotional loneliness, in contrast to social loneliness, is associated with the quantity of social contact as well as quality of these contacts (Murphy, 2000). Admittedly, the presence of social bonds could prevent deterioration in social relationships and mental wellbeing during adverse life events, such as a pandemic. In contrast to our expectations, social support did not predict changes in social relationships due to the COVID-19 restrictions. To our knowledge, this is the first empirical exploration of the impact of COVID-19 on social relationships within a forensic psychiatric population. Although data was limited because information regarding the impact of COVID-19 was gathered through a self-developed, brief questionnaire, this study contributes directly to knowledge regarding a complex, underexposed population during the unusual circumstances of the COVID-19 pandemic. Next, a mixed methods approach was used, which provided broader and more in-depth information. Finally, this study distinguished between social and emotional loneliness, confirming the difference between these constructs in a forensic outpatient population. Several methodological issues should be noted. Time and resources were limited, as questionnaires had to be implemented alongside ongoing assessments of an RCT, and due to the rapidity of the changing circumstances (the COVID-19 crisis) during the study. Besides, since this study examined a specific population of forensic outpatients with pre-identified social network-related problems, generalization of the results to other forensic populationsmight not be justified. Finally, this study focused on social relationships
RkJQdWJsaXNoZXIy MjY0ODMw