key: cord-0716333-eqehw533
authors: Fornara, Ferdinando; Mosca, Oriana; Bosco, Andrea; Caffò, Alessandro O.; Lopez, Antonella; Iachini, Tina; Ruggiero, Gennaro; Ruotolo, Francesco; Sbordone, Filomena Leonela; Ferrara, Antonella; Cattaneo, Zaira; Arioli, Maria; Frassinetti, Francesca; Candini, Michela; Miola, Laura; Pazzaglia, Francesca
title: Space at home and psychological distress during the Covid-19 lockdown in Italy
date: 2021-12-13
journal: J Environ Psychol
DOI: 10.1016/j.jenvp.2021.101747
sha: 1df107fbb15f8af2013b0fee817ac95751186722
doc_id: 716333
cord_uid: eqehw533

Prolonged periods of restrictions on people's freedom of movement during the first massive wave of the COVID-19 pandemic meant that most people engaged in all their daily activities at home. This suggested the need for the spatial features of the home and its occupants' perception of them to be investigated in terms of people's wellbeing. The present study was conducted on a large sample (N = 1354) drawn from different Italian regions. It examined the relationship between the “objective” and “subjective” dimensions of the home, measured in terms of objective home crowding and satisfaction with the space at home, in relation to perceived stress and the perceived risk of COVID-19 infection during the lockdown. The results showed that perceived stress is influenced by objective home crowding through the mediation of satisfaction with the space at home. These associations were more pronounced in younger generations. The negative association between satisfaction with the space at home and perceived stress was higher, the lower the perceived COVID-19 risk.

During a national lockdown imposed by the Italian government from March to May 2020 to combat 28 the first wave of the COVID-19 pandemic, people were obliged to stay at home all day (09.03.2020, 29 DPCM #iorestoacasa -I stay at home). They were only allowed to go out for necessities, such as to 30 purchase food or medicines, or to work if smart working was impossible. The COVID-19 outbreak 31 changed people's habits, routines and lifestyles, affecting human relationships and work productivity 32 all over the country. Streets remained deserted and the fear of infection a constant companion. The 33 experience of life at home was strongly affected too, especially during periods of enforced quarantine 34 (Rogers & Power, 2020) . Home became the place where most of the population conducted most or 35 all of their daily activities. Its occupants worked, studied, socialized, and engaged in physical exercise 36 routines, sharing the available space throughout the day, sometimes not without family conflicts and 37 tensions (Prime, Wade, & Browne, 2020) . The arrival of the COVID-19 pandemic led to a 69% 38 increase in the number of people in Italy working remotely (Savic, 2020). Numerous narratives have 39 emerged regarding the meaning of 'home' in these pandemic times (Devine-Wright et al., 2020), 40 some positive (home as a safe and healthy place, peaceful and restful, with more time to spend with 41 the family), some negative (home as a place of isolation, loneliness, threat, oppression and 42 imprisonment). 43

The central role of the home was dramatically emphasized during the COVID-19 lockdown, 44

suggesting the need to see it as more than just a physical living space. It is important to its occupants' 45 social and psychological wellbeing (Daniela et al., 2020) . This has shifted the focus to the spatial 46 adequacy of people's homes as a factor to consider in efforts to reduce the psychological distress 47

Besides the size of a home, another important issue concerns its spatial configuration (Campagna, 78 2016) . Partitions convey separation and depth, protecting against unwanted stimuli and intrusions 79 (Evans, Lepore, & Schroeder, 1996) . This relates to social spacing aspects, such as crowding and 80 privacy, which are closely related (Bell et al. 2001 ) because they both concern the interface between 81 spatial layouts and people. As Gatersleben and Griffin (2017) reported, crowding and (lack of) 82 privacy have been among the most often studied social-environmental stressors. 83

The stressful impact of crowded conditions has been demonstrated in various settings, such as offices 84 (Veitch, 2012) , correctional facilities (Wener, 2012) , and students' dormitories (Baum et al., 1981) . 85

In a sample of US college students, Evans, Lepore and Schroeder (1996) found smaller spaces at 86 home associated with higher levels of psychological distress. This effect seems to emerge not only in 87 noncontact cultures (as in Northern European and North American societies), but also in contact 88 cultures (in Latin America, for instance), as shown by Evans, Lepore, and Allen (2000). The stressful 89 influence of chronic residential crowding has been judged to be "moderately strong" ( has to do with "feeling too close to others" and "how distant one feels from others in his or her space" 111 (Thornock et al., 2019, p. 40) . For instance, Rodgers (1982) found that the relationship between 112 satisfaction with a community, neighborhood and dwelling related more to perceived crowding than 113 to objective crowding. Torshizian and Grimes (2020) reported instead that perceived crowding and 114 various objective crowding measures carried much the same weight in terms of people's residential 115 satisfaction. The dichotomy between objective and subjective crowding recalls the broader distinction 116 between objective and subjective assessment of environmental quality of places, e.g. concerning the 117 urban contexts (Gifford, 2002; Bonaiuto & Alves, 2012) and the healthcare settings (Fornara & 118 Andrade, 2012). In this regard, some studies (Andrade e al., 2013; Fornara, 2005) found that users' 119 perceived quality of hospital environmental features (i.e., a kind of subjective assessment) mediate 120 the relationship between expert ratings of the hospital design (i.e., a kind of objective assessment) 121 and a global response of users' satisfaction towards their experience. 122 123

Age needs to be borne in mind when addressing the influence of the spatial dimensions of homes. 125

Zhang et al. (Zhang et al., 2018) found that several features of a home -such as ownership, type, size, 126 J o u r n a l P r e -p r o o f number of bedrooms, and the presence of living rooms or bathrooms -predicted older adults' level 127 of satisfaction with their homes, whereas only the size of the home and the number of bedrooms were 128 significant predictors for younger people. 129

The Tiny House Community Survey conducted by Boeckerman and colleagues (Boeckerman, 130

Kaczynski, & King, 2019) identified age as a significant sociodemographic predictor of respondents' 131 satisfaction with their tiny homes: people from 40 to 66 years old were more satisfied than younger 132 residents (from 19 to 39 years old). Other studies found that residential satisfaction tends to increase 133 with age (Lu, 1999; Mridha, 2020) . The home probably tends to have a more central role in the lives 134 of older adults, who are more likely to organize their daily activities around their place of residence Both the above-mentioned research findings and the lifestyle changes prompted by the pandemic 142 suggest that age could play a significant part in both residential satisfaction (in relation to the actual 143 space available) and stress responses (in relation to satisfaction with the space at home). This is 144 because during lockdown the home would presumably be the place where older people already 145 conducted most of their activities, whereas younger people would have generally been obliged to 146 change their habits and rearrange their daily routines. 147 148

The present study aimed to explore the relationship between home crowding, residential satisfaction, 150 and perceived stress during a period of lockdown, when people were obliged to stay at home and 151 environmental variables were likely to be more influential than usual. A first aim was to assess the 152 J o u r n a l P r e -p r o o f impact of home crowding on perceived stress because very few studies have analyzed this specific 153 issue (Evans et al., 1996 (Evans et al., , 2000 . Our study drew theoretical and applicative support from the strong 154 interest in the psychology of home environments (e.g., Graham, Gosling, & Travis, 2015) prompted 155 by the COVID-19 emergency and the associated restrictions on people's movements (e.g., 156

https://www.covidfamilystudy.org/). A second aim was to examine the link between home crowding 157 and residential satisfaction. Various studies (e.g., Ibem & Aduwo, 2013; Zhang et al., 2018) found an 158 influence of a home's size and level of crowding on the prediction of residential satisfaction. The 159 novelty of our work lies in that it analyzed the three variables -home crowding, perceived stress, and 160 residential satisfaction, and the associations between them -in the same study. We focused on the 161 spatial dimension of residential satisfaction, since it represents the "subjective" side of home 162 crowding. In particular, we tested the hypothesis that the relationship between crowding and 163 perceived stress could be mediated by satisfaction with the space at home. We also considered the 164 moderating role of the perceived risk of COVID-19 and age, based on the relationships between 165 perception of safety, age, and satisfaction with the space at home (Ahn & Hedge, 2011). To achieve 166 our aims, we estimated a moderated mediation model (see Figure 1 ) where perceived stress during 167 lockdown was expected to be influenced by objective home crowding (an "objective" measure of the 168 actual space available), both directly and also indirectly through the mediation of satisfaction with 169 the space at home (i.e., a "subjective" measure of environmental satisfaction, including aspects related 170 to perceived crowding, privacy, lighting conditions, and more generally of satisfaction with one's 171 home). We also considered the role of perceived risk of COVID-19 and age as moderators in the 172 model. 173

We tested the following hypotheses. consists of 10 items (e.g. "In the last month, how often have you been upset because of something 235 that happened unexpectedly?", "In the last month, how often have you found that you could not cope 236 with all the things that you had to do?") rated on a 5-point Likert scale, ranging from 0 = "never" to 237 4 = "very frequently". These items relate to feelings and thoughts during the previous month (i.e. 238 during lockdown in our case), and participants indicated how often they had felt or thought a certain 239 way (α = .87). 240

Satisfaction with the space at home -four questions investigated respondents' satisfaction regarding 241 the spatial aspects of their homes: 1) "How satisfied are you generally with your home?", 2) "How 242 satisfied are you with the space, or square footage, of your home?"; 3) "How satisfied are you with 243 your privacy at home?"; and 4) "How satisfied are you with the natural light in your home?". These 244 items were rated on a Likert scale ranging from 1 = not at all satisfied to 5= completely satisfied (α 245 = .78). 246

Objective home crowding -this was operationalized in terms of the number of occupants divided by 247 the number of rooms in the home, i.e., the people-per-room ratio most often used in the literature 248 Sociodemographic information was also collected, including age, gender, education level, marital 259 status, having children or not, and place of residence (see Table 1 ). 260 261 J o u r n a l P r e -p r o o f 

Recent methodological approaches suggest that mediation analysis should be conducted on a formal 285 significance test of the indirect effect "ab", obtained from the product of the regression coefficients 286 between the predictor and mediator variables ("a") and the mediator and outcome variables ("b"). 287

Bootstrap confidence intervals afford a superior test of the significance of indirect effects in mediation 288 models, however (Hayes, 2013; MacKinnon et al., 2002) . We thus tested our mediation hypothesis 289 using the PROCESS program made available by Hayes (Hayes, 2013) . Table 2 Table 2 shows the descriptive statistics concerning the model measures and zero-order correlations 310 between variables, and Table 3 shows the results of the moderated mediation analysis. Perceived stress is negatively associated with Satisfaction with the space at home (r = -.25, p < .001) 318

and Age (r = -.38, p < .001), and positively associated with Objective home crowding (r = .14, p < 319

.001) and Perceived COVID-19 risk (r = .12, p < .001). Regarding the moderator Perceived COVID-19 risk, the effect of Satisfaction with the space at home 332 on Perceived stress is significant for both high and low levels of Perceived COVID-19 risk. As 333 concerns the direction of this moderating effect, the 'Satisfaction with the space at home x Perceived 334 COVID-19 risk' interaction reveals a significant effect in the expected direction (H5) on Perceived 335 stress (B = 0.020, t = 2.24, p < .001), since the moderated relationship is stronger the lower the 336 Perceived COVID-19 risk (see Figure 2) . 337 In the second stage of the model, the effect of Satisfaction with the space at home on Perceived stress 358 is significant for both younger and older respondents. As for the direction of this moderating effect, 359 the 'Satisfaction with the space at home × Age' interaction has a significant effect (H7) on Perceived 360 stress (B = 0.0032, t = 2.29, p < .01), and the moderated relationship is stronger for younger 361 respondents (see Figure 4) . pandemic. The mediating role of Satisfaction with the space at home was significant for different 386 levels of both Age and Perceived COVID-19 risk, but its effect was stronger for younger people, and 387 for those who perceived a higher risk of catching the infection. 388

As concerns H1, we confirmed that Satisfaction with the space at home increases when Objective 389 home crowding decreases, consistently with previous findings on the influence of "objective" home As concerns the perceived COVID-19 risk, alongside its predictable significant association with the 407 level of stress (i.e., the higher the perceived risk, the greater the stress), this variable also emerged as 408 a moderator between Satisfaction with the space at home and Perceived stress. As expected (H5), the 409 strength of the association between these two variables is greater the lower the Perceived COVID-19 410 risk. In other words, appreciating the space available at home is much more important in containing 411 stress levels for people who are less concerned about the COVID-19 risk than for those more worried 412 about the pandemic. 413

As well as confirming that residential satisfaction increases with aging (Campbell, Converse, & 414 Rodgers, 1976; Lu, 1999; Mridha, 2020; Zhang et al. 2018) , older people also seem to be less affected 415 by home crowding than younger people, as hypothesized in (H6). This is consistent with previous 416 reports of older adults being more satisfied with their tiny homes than younger generations 417 (Boeckerman et al., 2019). In our study, older people also felt less stressed than younger people, 418 although it has been amply acknowledged that the harm caused by COVID-19 disease increases with 419 age ( The study outcomes point to the crucial importance of carefully assessing the influence of satisfaction 454

with the space at home on the association between objective home crowding and perceived stress. 455

Age reveals an important role in these relationships, with younger people's satisfaction with the space 456 at home being more affected by objective home crowding, and their consequent perceived stress is 457 more severe than in older people. The mitigating effect of satisfaction with the space at home on 458 perceived stress was also found weaker when the perceived COVID-19 risk was greater. 459

Overall, a coherent picture emerges from our results: home means a safe haven, especially for the 460 elderly, but for the younger generations its objective and subjectively-perceived spatial features have 461 a key role in mitigating the stressful effects of having to stay at home under lockdown. Taken together, 462 these findings show that issues relating to the space available at home -in terms of residential 463 satisfaction and crowding -are fundamental to people's wellbeing and perceived stress in response 464 to the restrictions imposed by the COVID-19 emergency. It is therefore important to consider these 465 aspects with a view to designing adequate, flexible living spaces in the homes of today and tomorrow. 466

In conclusion, it is to mention that the same notion of pandemic has been questioned, and a syndemic 467 approach was recently proposed (Horton, 2020) , in order to demonstrate how an integrated 468 perspective to understanding and coping with diseases can be far more successful than simply 469 controlling epidemics or treating individual patients. Such an approach advocates the inclusion of the 470 economic, social, and environmental factors that could amplify (or buffer) the effect of diseases 471 (Singer, Bulled, Ostrach, & Mendenhall, 2017) , as in the case of the COVID-19 pandemic. Given 472 that poor-quality housing is associated with various negative health outcomes, including chronic 473 diseases (Hu, Roberts, Azevedo, & Milner, 2021), it is essential that policy makers and other public 474 health stakeholders take into account the pivotal role of house conditions for individual's wellbeing, 475 considering that, even when hopefully the pandemic will be over, many people will continue to work 476 from home, either entirely or partially (Guyot & Sawhill, 2020) . The data examined in this study will be made available upon reasonable request. 

Users' Evaluative Responses to Spatio-Physical Humanization: The Case of Hospital 587

Designing Social Innovation: Planning, Building, Evaluating 588

Healthcare environments

Environmental and Conservation Psychology

Residential place attachment as an 592 adaptive strategy for coping with the reduction of spatial abilities in old age

Healthy residential environments for the elderly

Environmental stress

Environmental psychology: Principles and practice

Multiple effects of community and household 600 crowding

The psychology of home environments: A call 602 for research on residential space

Telecommuting will likely continue long after the pandemic

Introduction to Mediation, Moderation, and Conditional Process Analysis: A 607 regression-based approach

Place attachment and 609 place identity in natives and non-natives

Offline: COVID-19 is not a pandemic

Home ownership and subjective wellbeing in urban China: Does owning a house make 612 you happier?

The role of built and social 614 environmental factors in Covid-19 transmission: A look at America's capital city

Home ownership and residential satisfaction

Assessment of residential satisfaction in public housing in Ogun 619

Perceived environmental 621 housing quality and wellbeing of movers

The Oxford Handbook of 624 Environmental and Conservation Psychology

Schools for the twenty-first century: School design and 626 educational transformation

The need for space and residential satisfaction

What makes neighborhood different from home and city? Effects of place scale 630 on place attachment

Determinants of residential satisfaction: Ordered logit vs. regression models. Growth 632 and Change

A 634 comparison of methods to test mediation and other intervening variable effects

Understanding environmental quality through quality of life studies: The

DAS and its use of subjective and objective indicators

A 640 nationwide survey of psychological distress among Italian people during the COVID-19 pandemic

Immediate psychological responses and associated factors

The COVID-644 19 outbreak and psychological distress in healthcare workers: The role of personality traits, 645 attachment styles, and sociodemographic factors

The effect of age, gender and marital status on residential satisfaction

Dimensions that explain attachment to the 649 home/Dimensiones que explican el apego a la vivienda

Satisfaction with housing and quality of life

Addressing moderated mediation hypotheses

Risk and resilience in family well-being during the 655 COVID-19 pandemic

A nationwide survey of psychological 657 distress among Chinese people in the COVID-19 epidemic: Implications and policy 658 recommendations

Density, crowding, and satisfaction with the residential environment

Housing policy and the COVID-19 pandemic: The importance of 662 housing research during this health emergency

Attachment to place and the representation of the life 665 course by the elderly

Gender-related time course of sleep disturbances and psychological symptoms during the COVID-19 669 lockdown: A longitudinal study on the Italian population

COVID-19 and work from home: Digital transformation of the workforce

Improving response rates to income questions

Section on Survey Research Methods, Proceedings

Syndemics and the biosocial 675 conception of health

Psychological stress 677 and gender differences during COVID-19 pandemic in Chinese population

There's no place like 679 home: The associations between residential attributes and family functioning

Household crowding measures: A comparison and external test 682 of validity

The Oxford Handbook of 684 Environmental and Conservation Psychology

The relevance of social interactions on housing 686 satisfaction

Immediate psychological 688 responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) 689 epidemic among the general population in China

A conceptual framework for residential satisfaction

Home Environments

The Environmental Psychology of Prisons and Jails: Creating humane spaces in 694 secure settings

COVID-19: The gendered impacts of the outbreak. The 696

Housing conditions and life satisfaction in urban China

(2020). COVID-19 and living spaces challenge. Well-being and public health recommendations for 561 a healthy, safe, and sustainable housing. Acta Biomedica, 91(9). 562