Tracing "Fearbola": Psychological Predictors of Anxious Responding to the Threat of Ebola

Getting comfortable with physical discomfort: A scoping review of interoceptive exposure in physical and mental health conditions

Interoceptive exposure (IE) involves the use of exercises, activities, or tasks to intentionally induce (or exacerbate) physical symptoms in the body, to challenge misconceptions about the harmful nature of the physical symptoms that maintain fear and problematic avoidance. IE was originally developed for the cognitive behavioral treatment and prevention of panic disorder. Bodily sensations and concern about physical symptoms are common features in many conditions, not limited to panic disorder. For this reason, IE could be theoretically relevant to cognitive behavioral intervention for many psychological, behavioral, and medical conditions. Yet, IE remains relatively underrecognized and underused as an intervention. Exposure involves feeling discomfort before experiencing relief; thus, it is often perceived as an aversive, unsafe, and illogical intervention because of the seemingly paradoxical approach. We conducted a systematic literature search for a scoping review with the aim of locating published studies on IE to understand how it has been studied beyond panic disorder. Studies focused solely on panic disorder were excluded. We were able to identify and extract data from 132 studies (published between 1992 and 2022), though this published literature is difficult to find. The use of IE has been widely investigated in conditions beyond panic disorder, although evidence for its efficacy is difficult to isolate from other forms of exposure and cognitive behavioral features. There is the strongest evidence for the efficacy of IE as a part of multicomponent cognitive behavioral treatments for posttraumatic stress disorder, health anxiety, irritable bowel syndrome, and to aid in benzodiazepine discontinuation. Interventions that were primarily or exclusively IE-based did not consistently or directly influence claustrophobia fear, separation anxiety, suicidality, insomnia symptoms, cigarette or drug abstinence, or pain-related fear. No serious adverse events were reported in any study. Studies of IE require larger sample sizes, detailed descriptions and rationale of IE exercises, higher IE dosing, extended follow-up assessment, and documentation of safety. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Psychometric properties of anxiety sensitivity Index-3 among Chinese college students and its preliminary application among this population experiencing campus lockdown

PURPOSE

Anxiety sensitivity (AS) refers to fear of anxiety-related sensory arousal and has been revealed to be associated with increased psychological distress and mental problems. Although Anxiety Sensitivity Index-3 (ASI-3) has been confirmed to be effective in evaluating this construct, whether it is consistently applicable in college students is still elusive. The present study aimed to examine the psychometric properties and measurement invariance of Chinese version of ASI-3 (C-ASI-3) among college students experiencing campus lockdown due to novel coronavirus disease 2019 (COVID-19) pandemic.

METHODS

A total of 1532 Chinese college students (397, 25.9% males) aged between 16 and 25 were included in this study. Confirmatory factor analysis (CFA) was used to verify the factor structure of C-ASI-3. Multi-group CFA was conducted for analysis of measurement invariance with regard to gender. McDonald's omega values were computed for examination of scale reliability. For criterion, convergent, and divergent validity, average variance extracted (AVE) values for C-ASI-3 subscales, difference between square root of AVE for each factor and inter-factor correlation, as well as pearson correlation and partial correlation between the C-ASI-3 and other three scales, including the Depression, Anxiety, and Stress Scale-21 (DASS-21), the State-Trait Anxiety Inventory (STAI), and the Fear of COVID-19 scale (FCV-19 S) were evaluated.

RESULTS

The C-ASI-3 presented a three-factor scale structure with fit indices being as follows: χ2/df = 11.590, CFI = 0.938, RMSEA = 0.083, SRMR = 0.042. Strict measurement invariance was reached across gender. Regarding convergent validity, the C-ASI-3 had a high correlation with the DASS-21 (r = 0.597, p < 0.01) and the STAI (r = 0.504, p < 0.01). All AVE values for C-ASI-3 subscales were above 0.5. In terms of divergent validity, the C-ASI-3 had medium correlation with the FCV-19 S (r = 0.360, p < 0.01). Square of root of AVE for each factor was higher that inter-factor correlation. McDonald's omega values of the three dimensions ranged from 0.898 ~ 0.958.

CONCLUSION

The C-ASI-3 has acceptable psychometric properties among college students. College students with different gender have consistent understanding on the scale construct.

Imprint of ancestral and modern threats in human mind - experience of fear, disgust, and anger

Introduction

Threats to our survival are often posed by the environment in which humans have evolved or live today. Animal and human ancestors developed complex physiological and behavioral response systems to cope with two types of threats: immediate physical harm from predators or conspecifics, triggering fear, and the risk of infections from parasites and pathogens leading to the evolution of the behavioral immune system (BIS) with disgust as the key emotion. Here we ask whether the BIS has adapted to protect us from pandemic risks or poisoning by modern toxic substances.

Methods

We have developed a survey comprised of 60 vignettes describing threats evoking fear and disgust belonging to one of the three main categories of threats: (1) ancestral, (2) modern, and (3) pandemic of airborne disease. Each vignette was evaluated on a 7-point Likert scale based on fear, disgust, and anger. Respondents also completed an assessment battery.

Results

The results show that the strongest fear is triggered by modern threats (electricity, car accidents), while the highest disgust is evoked by ancient threats (body waste products, worms). Disgust does not respond to modern threat stimuli such as toxic substances or radioactivity as these evoke mainly fear and anger. A discriminant factor analysis classified nine out of 10 pandemic disgust vignettes into the ancestral disgust category, convincingly assigning the pandemic disgust threats to the ancestral type. Gender, age, and type of education were significant moderators of emotional responses across all threat categories.

Discussion

Our study reveals that while fear is more context-dependent, particularly triggered by modern threats, disgust operates on an evolutionarily hardwired basis, making it less effective against contemporary risks. Furthermore, disgust experienced during a pandemic outbreak is more closely aligned with ancestral disgust-related threats tapping into evolutionary ancient survival circuits of the BIS. However, as disgust declines with age, the brain must adaptatively shift the emotional processing from disgust to fear to protect older adults from contamination risks. Finally, our study reveals that pandemic fear is better predicted by specific behaviors rather than general anxiety, suggesting a need for new assessments.

State of the Science: Disgust and the Anxiety Disorders

Anxiety disorders have long been conceptualized as disorders of fear, while other emotions have largely been overlooked. However, an emerging literature has increasingly implicated disgust in certain anxiety-related disorders, including obsessive-compulsive disorder, specific phobias (e.g., spider phobia), health anxiety, and posttraumatic stress disorder. Roughly two decades of research has accumulated evidence identifying various mechanisms linking disgust-related phenomena to these disorders. In the present "State of the Science" review, we sought to summarize the current state of the literature with respect to disgust-related mechanisms in anxiety disorders, including trait-level vulnerabilities (e.g., disgust proneness), cognitive processes (e.g., biases of attention and memory), and associated learning mechanisms (e.g., evaluative conditioning). Research in these areas has revealed important ways in which disgust differs from fear-related phenomena, which have important treatment implications. From there, we sought to summarize research on laboratory interventions that attempt to target and attenuate disgust, as well as the early research on formal cognitive-behavioral treatments that integrate disgust-related interventions for anxiety disorders. Although the past two decades of research have revealed important insights related to the role of disgust in psychopathology, much remains to be learned in this area. We propose some future directions, emphasizing the importance of a guiding framework that highlights studying disgust-related mechanisms across different levels of analysis.

Role of interoceptive fear and maladaptive attention and behaviors in the escalation of psychopathology-a network analysis

The complex interplay of fear, attention, and behavior toward bodily sensations with psychopathological symptoms and how they mutually influence and potentially reinforce one another remains to be fully elucidated. In this study, we used a network analytical approach to unravel these complex interactions. Specifically, we aimed to identify central symptoms and etiologically relevant factors that might be associated with anxiety and depressive core symptoms. To this end, the following clusters were assessed in 791 adults: interoceptive fear, interoceptive attention, maladaptive behaviors related to bodily sensations, and core symptoms of anxiety and depression. This network was modeled using a Gaussian Graphical Model. Central variables (nodes) were identified using centrality indices and bridge analysis. Self-examination and attention to bodily sensations emerged as central nodes. Moreover, time spent paying attention to bodily sensations, fear of anxiety-related sensations, and self-examination were identified as central bridge nodes, that is, central nodes connecting psychopathologically relevant symptom clusters. The present study indicates that fear of bodily sensations, the amount of attention and time spent focusing on somatic sensations, and self-examination are central factors. The findings suggest potential targets for future longitudinal studies on the impact of these factors for the escalation of anxiety and depressive symptoms.

Social Representations and Symbolic Coping: A Cross-Cultural Discourse Analysis of the COVID-19 Pandemic in Newspapers

This study used a framework grounded in social representations theory to investigate cross-cultural variation and consistency in the discursive construction of the COVID-19 pandemic by the mass media, in the week following WHO's declaration of a global pandemic in March 2020. News reports from media outlets in the United Kingdom and China were sourced, with articles from the most popular media sources selected for analysis. Four discourses were identified to be the most prominent representations present throughout these accounts: war; other illnesses; a general emergency; an unknown situation. The findings demonstrated consistency with past research, highlighting how the sociogenesis of social representations in the case of the COVID-19 pandemic followed a similar pattern to other novel infectious disease outbreaks. Consistency between UK and Chinese media accounts was identifiable throughout the construction of these discourses; however, variation was detectable regarding use of culturally relevant anchors for existing illness representations, along with Chinese media accounts constructing images of a comparatively optimistic local situation, whilst depicting the rest of the world as in the midst of a global emergency. Future research has the potential to build on these findings by going beyond media representations to explore actual lay population beliefs, attitudes, and opinions, considering how they compare to the representations portrayed in mass-mediated news reports.

The relationship between maladaptive health beliefs, pandemic-related stress, and health anxiety during the COVID-19 pandemic

BACKGROUND

Research has demonstrated that people experience specific distress and anxiety regarding COVID-19. This distress may consist of interconnected symptom categories corresponding to a COVID stress syndrome. Susceptibility to COVID stress syndrome may be related to one's maladaptive health beliefs; however, no research has investigated the association between maladaptive health beliefs and COVID stress. The present study explored the impact of health beliefs on COVID stress, health anxiety, and associated psychological constructs.

PARTICIPANTS AND PROCEDURE

This cross-sectional survey study included 221 adults (M age = 20.59, SD = 2.28). Participants completed an online survey including demographic questionnaires and self-report measures of health beliefs, COVID stress, health anxiety, and related psychological constructs.

RESULTS

Health anxiety, anxiety sensitivity, state/trait anxiety, intolerance of uncertainty, and depression accounted for significant variance in COVID stress (F(6, 214) = 11.18, R2 = .24, p < .001). Health beliefs (i.e., perceived likelihood of illness, medical service inadequacy, and difficulty coping) were associated with greater COVID stress, although health beliefs were not found to mediate the relationship between health anxiety and COVID stress.

CONCLUSIONS

Health beliefs were associated with greater COVID stress, although health beliefs did not mediate the relationship between health anxiety and COVID stress. The relationship between health anxiety and COVID stress may be better explained by other COVID-related cognitions (e.g., vaccine efficacy, dangerousness of COVID-19). The findings highlight the importance of peoples' health beliefs during the pandemic. Given anxiety's influence on peoples' behavioural responses to the pandemic, further research should identify COVID-specific cognitions for prevention of COVID stress and health anxiety.

Context-Dependent Responses to the Spread of COVID-19 Among National and International Students During the First Lockdown: An Online Survey

BACKGROUND

Restrictions to minimize social contact was necessary to prevent the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus but may have impacted individuals' mental well-being. Emotional responses are modulated by contextual information. Living abroad during the coronavirus disease 2019 (COVID-19) pandemic may have boosted the feeling of isolation as the context is unfamiliar.

OBJECTIVES

This study compared the psychological impact of social distancing in national students (living in a familiar context) versus international students (living in an unfamiliar context).

METHODS

During March/April 2020 (first lockdown in the Netherlands), 850 university students completed an online survey. Structural equation modeling (SEM) was conducted to compare how students' responses to the virus were predicted by health anxiety, emotional distress, and personal traits.

RESULTS

Compared with national students, international students showed higher levels in 4 identified factors (COVID-19-related worry, perceived risk of infection, distance from possibly contaminated objects, distance from social situations). The factors were mainly predicted by health anxiety across international students, while emotional distress and individual traits (eg, intolerance of uncertainty) played a role across national students.

CONCLUSIONS

In the familiar context, individual characteristics (traits) predicted the responses to the virus, while the unfamiliar context drove individuals' health-focused responses. Living in a foreign country is associated with psychological burdens and this should be considered by universities for more pronounced social support and clear references to health-related institutions.

Relations Between Guardians and Domestic Animals During the Sars-Cov-2 Pandemic in Brazil

OBJECTIVE

The aim of this study was to evaluate how relationships between guardians and domestic animals were established and their possible effects during the COVID-19 pandemic period in Brazil.

METHODS

Data were collected by completing an online questionnaire. Throughout the national territory, 2002 people completed the questionnaire, while respecting social distancing from January 20, 2021, to March 20, 2021. The inclusion and exclusion criteria were 'to own pets' or 'those who had them during the period of quarantine' in Brazil. The data obtained were treated qualitatively through discourse analysis and content analysis, while the quantitative data were tabulated by the questionnaire application platform itself.

RESULTS

The results showed that 97% of the participants were affected by the coronavirus pandemic in Brazil and that of these, 95.5% stated that their pet was important to overcome and bear bad feelings during the period of social isolation. It was possible to observe through the participants' reports through the online questionnaire that the relationships with their pets were deepened during the pandemic period, and that these had an important role in overcoming bad emotions caused by social distancing.

CONCLUSION

It was concluded that due to these relationships, behaviors such as anxiety and sadness were reduced and the pets themselves also showed an increase in affective behaviors in relation to their guardians.

An empirical study of entrepreneurial leadership and fear of COVID-19 impact on psychological wellbeing: A mediating effect of job insecurity

The empirical study proposes a model for investigating the effect of entrepreneurial leadership on job insecurity and employee psychological wellbeing during COVID-19 based on the combined theoretical grounds of The Conservation of Resources Theory and Social Learning. To explore the job insecurity relationship with psychological wellbeing, and measure the impact of Fear of COVID-19, an empirical study was conducted on a sample of 408 employees in Croatia. The data of the cross-sectional study was collected in November and December 2020. A strong influence of job insecurity on the psychological wellbeing of employees has been identified. Furthermore, fear of COVID-19 was found to have adverse psychological effects on wellbeing. The theorized positive impact of entrepreneurial leadership on job insecurity was not supported by the evidence. The strong point of our contribution lies in the finding that the entrepreneurial leadership style alone does not buffer against job insecurity, thus pointing that the more comprehensive inquiry into other organizational factors, such as coping, learning abilities, developmental opportunities, personal disposition, and pressure bearing. The research is the first step toward enhancing our understanding of the entrepreneurial dimension of transactional psychology. The observations we recorded have implications for research into the study of the mental processes and their impact on organizational proactive behavior.

COVID-19 anxiety and mental health among university students during the early phases of the U.S. pandemic

OBJECTIVE

This study examined the impact of COVID-19 in the early stages of the pandemic on university students in the U.S. by: (1) characterizing COVID-19-related disruptions; (2) evaluating health anxiety, obsessive-compulsive (OC), depression, and stress symptoms; and (3) analyzing the unique role of COVID-19 anxiety on mental health outcomes, after accounting for relevant variables.

PARTICIPANTS

Participants included 263 students (63.9% female).

METHODS

Data were collected online between March 19, 2020 and May 1, 2020.

RESULTS

Participants screened positive for health anxiety (6.5%), OC symptoms (48.7%), or depression (29.7%). COVID-19 anxiety was positively associated with mental health symptoms. After controlling for demographics and COVID-19 impact, COVID-19 anxiety accounted for significant variance in health anxiety, OC symptoms, and stress.

CONCLUSIONS

Findings demonstrate the vast impact of COVID-19 on mental health among university students and provide guidance for identifying mental health priorities in the context of public health crises.

Anxiety sensitivity elevates the risk of mental health problems in employees with higher probability of contacting COVID-19 at work

Individuals with increased risk of being in contact with COVID-19 cases at work have been reported to suffer from higher fear of infection and associated mental health problems. The present study examines whether this risk is further increased by higher anxiety sensitivity (AS, i.e., fear of bodily symptoms such as breathlessness, which also are core symptoms of COVID-19) that is also known to be associated with an increased risk of psychopathology. In spring 2020, 783 German health care and social workers participated in a cross-sectional online-survey, in which anxiety sensitivity, depression, anxiety, health anxiety, fear of a COVID-19 infection as well as panic symptoms were assessed. Of these participants, 28.7% affirmed contact with COVID-19 cases, which was associated with greater fear of the virus. Individuals with high AS reported more severe anxiety, health anxiety, depressive symptoms, as well as incident and recurrent panic symptoms. Moreover, the risk association of exposure to COVID-19 cases at work with health anxiety, general anxiety, and panic symptoms was further increased by higher levels of AS. These findings suggest that especially employees with contact to COVID-19 cases who also are high in AS might profit from targeted interventions to prevent excessive fear and associated mental health problems.

A longitudinal assessment of variability in COVID-19 vaccine hesitancy and psychosocial correlates in a national United States sample

Recent evidence suggests that COVID-19 vaccine hesitancy is not static. In order to develop effective vaccine uptake interventions, we need to understand the extent to which vaccine hesitancy fluctuates and identify factors associated with both between- and within-person differences in vaccine hesitancy. The goals of the current study were to assess the extent to which COVID-19 vaccine hesitancy varied at an individual level across time and to determine whether disgust sensitivity and germ aversion were associated with between- and within-person differences in COVID-19 vaccine hesitancy. A national sample of U.S. adults (N = 1025; 516 woman; M_age = 46.34 years, SD_age = 16.56, range: 18 to 85 years; 72.6 % White) completed six weekly online surveys (March 20 - May 3, 2020). Between-person mean COVID-19 vaccine hesitancy rates were relatively stable across the six-week period (range: 38-42 %). However, there was considerable within-person variability in COVID-19 vaccine hesitancy. Approximately, 40 % of the sample changed their vaccine hesitancy at least once during the six weeks. There was a significant between-person effect for disgust sensitivity, such that greater disgust sensitivity was associated with a lower likelihood of COVID-19 vaccine hesitance. There was also a significant within-person effect for germ aversion. Participants who experienced greater germ aversion for a given week relative to their own six week average were less likely to be COVID-19 vaccine hesitant that week relative to their own six-week average. This study provides important information on rapidly changing individual variability in COVID-19 vaccine hesitancy on a weekly basis, which should be taken into consideration with any efforts to decrease vaccine hesitancy and increase vaccine uptake. Further, these findings identify-two psychological factors (disgust sensitivity and germ aversion) with malleable components that could be leveraged in developing vaccine uptake interventions.

Assessing the predictors of adaptive and maladaptive Covid-19 preventive behaviours: an application of protection motivation theory

Despite the high death toll of the COVID-19 pandemic, reported rates of adherence to adaptive preventive health behaviours during the early wave of the pandemic were suboptimal for reducing the risk of disease spread. Additionally, some have adopted practices with the intention of preventing infection that have harmful consequences. Protection Motivation Theory (PMT), consisting of perceived vulnerability, severity, response efficacy, and self-efficacy, has been used to predict intentions to engage in behaviours in past pandemics, and can be extended to the COVID-19 outbreak. Three hundred and thirty-three American adults completed a survey in May 2020 through Amazon's Mechanical Turk. Ten behaviours recommended by the CDC and WHO and two 'maladaptive' behaviours presented in the media were selected for investigation. Binary logistic regressions were conducted to assess the impacts of demographic variables and PMT constructs on behaviour frequency. Perceived severity and vulnerability were not significant predictors of behaviour frequency. Behaviour specific response efficacy and self-efficacy were significant predictors of 11/12 (odds ratios: 2.70-6.22) and 10/12 (odds ratios: 2.59-4.64) behaviours, respectively. Age, gender, education, political ideology, perceived severity, and perceived vulnerability were generally unimportant predictors. Beliefs about the effectiveness of the behaviour and one's ability to carry out that behaviour consistently seem to be more important in predicting how often someone engages in that behaviour than the perceived dangerousness of COVID-19 and one's believed susceptibility to infection. These results suggest that interventions trying to modulate the likelihood of engaging in preventive behaviours should focus on the effectiveness of these behaviours in reducing risk of spread and the individual's ability to engage in these behaviours frequently rather than the dangerousness of the COVID-19 pandemic and the individual's risk of becoming infected.

Intolerance of uncertainty, fear of contamination and perceived social support as predictors of psychological distress in NHS healthcare workers during the COVID-19 pandemic

Psychological distress has been repeatedly quantified over the course of the pandemic, however this has not always included broader healthcare workers, and has mostly focused on prevalence and occupational factors. This study investigated intolerance of uncertainty (IOU), fear of contamination and perceived social support as key predictors of psychological distress in healthcare professionals, between the 10^th and 23 June 2020, during the first wave of the COVID-19 pandemic. This study was a cross-sectional, online survey design. Opportunity sampling was used to recruit to the study, primarily using social media sites and snowballing techniques. The final sample included 342 National Health Service (NHS) healthcare workers. IU (p < .001), gender (p < .001), fear of contamination (p = .007), perceived social support (p = .012), and age (p = .017) significantly predicted psychological distress in the sample and accounted for 36.2% of variance in psychological distress scores. IOU accounted for 28.2% of this variance. A two-way post hoc ANOVA, looking at gender and profession, showed a significant main effect of gender on psychological distress scores (F(1,218) = 7.156, p = .008, η_p² = .032), with females reporting significantly higher psychological distress scores compared to males. In conclusion, higher levels of intolerance of uncertainty, fear of contamination and lower levels of perceived social support significantly influenced higher scores of psychological distress. These factors should be considered when adapting and delivering evidence-based interventions to healthcare staff during this crisis.

The Effects of Expectations and Worries on the Experience of COVID-19 Symptoms

Introduction

The COVID-19 pandemic has been shown to have profound effects on both mental and physical health. Distress and widespread uncertainty about global events and personal risk are associated with increased worry and negative expectations that impact physical health. Thus, the current pandemic poses a possibility for the experience of nocebo effects.

Objective

To evaluate the likelihood of nocebo-induced COVID-19 symptoms in a US sample.

Methods

An online study on the mental health impact of COVID-19 asked participants to complete a set of biweekly surveys over a 6-month period between April 2020 and May 2021. We focus on responses from 3,027 individuals who reported never testing positive for COVID-19. We assessed the association between two types of worry and self-reported symptoms of COVID-19. We used multi-level models to examine variations across and within participants over time. We further investigated the effects of pre-existing health conditions and mental health status.

Results

There was a positive association between symptoms and both general (b= 2.56, p<0.01) and personal worry (b=2.77, p<0.01). However, worry reported at one timepoint was not specifically associated with symptoms reported two weeks later (p = 0.63, p=0.56). We also found that a greater number of prior clinical comorbidities and greater mental health burden were significant predictors of symptom reporting.

Conclusions

These results suggest that increased worries during the COVID-19 pandemic were associated with greater symptoms. Further studies investigating worry and symptoms in populations with confirmed negative COVID-19 tests or isolated populations will be needed to isolate the occurrence of true nocebo effects during the pandemic.

Psychological Correlates of Health anxiety in Response to the Coronavirus (COVID-19) Pandemic: a Cross-Sectional Online Study in Iran

Current models suggest health anxiety as a fundamental variable associated with fear and anxiety related to COVID-19. The investigation was carried out in separate two studies on the Iranian population. The first study aims to test the COVID-19 Anxiety Inventory (N = 202). The findings indicate a two-factor structure of the scale. Participants (N = 1638) completed the online survey anonymously in the second study, including the COVID-19 Anxiety Inventory, Short Health Anxiety Inventory, The Intolerance of Uncertainty Scale, Anxiety Sensitivity Index-3, Body Vigilance Scale, Depression Anxiety Stress Scales 21, and Contamination Cognitions Scale. Results showed that health anxiety, anxiety sensitivity, and body vigilance would significantly contribute to fears of contracting COVID-19. Moreover, the findings support a central role of intolerance of uncertainty in predicting COVID-19 anxiety. The study results provided both theoretical and practical implications for understanding psychosocial predictors during the COVID-19 pandemic.

Fear of COVID-19, stress and depression: A meta-analytic test of the mediating role of anxiety

OBJECTIVES

The COVID-19 pandemic has negatively affected the lives of millions of individuals physiologically, behaviorally, socially, and/or psychologically. Moreover, there is now much empirical evidence that mental health problems have increased during the pandemic period and these problems have various consequences. The changes in the mood states of individuals due to the pandemic underpins the rationale of the present study. The aim of the study was to identify the cross-sectional associations between fear of COVID-19, stress, anxiety, and depression by using two stage-meta-analytic structural equation modeling (TS-MASEM).

DESIGN

This is a meta-analytic structural equation modelling study.

METHOD

A systematic literature review initially identified 4840 studies. As a result of applying inclusion and exclusion criteria, 25 studies comprising 28 samples (reporting 120 effect sizes) were eligible for inclusion in the current TS-MASEM (N = 16,452).

RESULTS

The results showed significant associations between fear of COVID-19, stress, anxiety, and depression. Additionally, the mediation role of anxiety in the association between depression and fear of COVID-19 and stress was explored.

CONCLUSIONS

Although the results did not allow for causal inferences regarding depression, they provide insight into the possible consequences of fear of COVID-19 and comorbid problems for clinicians and researchers.

Is Anxiety Sensitivity Associated with COVID-19 Related Distress and Adherence among Emerging Adults?

We investigated whether anxiety sensitivity (AS) is associated with increased distress and adherence to public health guidelines during the COVID-19 pandemic among undergraduates, and whether increased distress mediates the relationship between AS and increased adherence. An online cross-sectional survey was conducted with 1318 first- and second-year undergraduates (mean age of 19.2 years; 79.5% females) from five Canadian universities. Relevant subscales of the Substance Use Risk Profile Scale (SURPS) and the Big Five Inventory-10 (BFI-10) were used to assess AS and neuroticism. Three measures tapped distress: the Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms, the Generalized Anxiety Disorder-7 (GAD-7) for anxiety symptoms, and the Brief COVID-19 Stress Scales (CSS-B) for COVID-19-specific distress. The COVID-19 Adherence scale (CAD) assessed adherence to COVID-19 containment measures. AS was significantly independently associated with higher general distress (both anxiety and depressive symptoms) and higher COVID-19-specific distress, after controlling age, sex, study site, and neuroticism. Moreover, AS indirectly predicted greater adherence to COVID-19 preventive measures through higher COVID-19-specific distress. Interventions targeting higher AS might be helpful for decreasing both general and COVID-19-specific distress, whereas interventions targeting lower AS might be helpful for increasing adherence to public health containment strategies, in undergraduates.

The effect of the COVID-19 pandemic on disgust sensitivity in a sample of UK adults

The COVID-19 pandemic led to the introduction of a range of infection prevention and control (IPC) measures that resulted in dramatic changes in people's lives however these IPC measures are not practiced consistently across the population. One predictor of an individual's responses to the pandemic is disgust sensitivity. Understanding how disgust sensitivity varies within the population could help to inform design of public health messages to promote more uniform behavioral change during future pandemics. To understand the effect of the current COVID-19 pandemic on an individual's pathogen disgust sensitivity we have compared pathogen disgust sensitivity during the current COVID-19 pandemic to baseline pathogen disgust sensitivity, determined prior to the COVID-19 pandemic, in the same sample of UK adults. We find that the COVID-19 pandemic did not alter overall pathogen disgust sensitivity suggesting that disgust sensitivity is stable despite IPC measures, public health messaging, media coverage and other factors associated with the COVID-19 pandemic.

The impact of the COVID-19 pandemic on the mental health of children with psychiatric diagnoses - multidimensional CCPCA Model

BACKGROUND

The study aimed to assess the severity of symptoms of anxiety and depression in children with previously diagnosed psychiatric disorders during the COVID-19 pandemic in Poland.

METHODS

Online questionnaires were used to investigate three groups of subjects: patients with a psychiatric diagnosis, primary school pupils, and children from children's homes. A total of 167 children with their parents or guardians participated in the study. In addition to basic statistics, a multidimensional Centroid Class Principal Component Analysis (CCPCA) model was used.

RESULTS

It was found that the strongest fear of the coronavirus was experienced by children from children's homes, while the most severe depressive symptoms and state anxiety were observed among patients diagnosed with psychiatric disorders. Parental care by assisting with school education and lack of close contact with other people (less than two metres) at parents/guardians' work had the most potent protective effect in reducing the fear of COVID-19.

CONCLUSIONS

There is a need for further research in children and adolescents to develop effective strategies for protecting their mental well-being when faced with social isolation or disease.

The Mental Health Impact of the COVID-19 Pandemic Second Wave on Shielders and Their Family Members

In March 2020, individuals shielding from coronavirus reported high rates of distress. This study investigated whether fear of contamination (FoC) and use of government-recommended behaviours (GRB; e.g., handwashing and wearing masks) were associated with psychological distress during February 2021. An online cross-sectional questionnaire assessed psychological distress in three groups (shielding self, shielding other/s, and control), and those shielding others also completed an adapted measure of health anxiety (α = 0.94). The sample (N = 723) was predominantly female (84%) with a mean age of 41.72 (SD = 15.15). Those shielding (self) demonstrated significantly higher rates of health anxiety and FoC in comparison to other groups (p < 0.001). The use of GRB was significantly lower in controls (p < 0.001), with no significant difference between the two shielding groups (p = 0.753). Rates of anxiety were higher when compared to March 2020 findings, except for controls. Hierarchical regressions indicated FoC and GRB accounted for 24% of variance in generalised anxiety (p < 0.001) and 28% in health anxiety, however, the latter was a non-significant predictor in final models. Those shielding themselves and others during the pandemic have experienced sustained levels of distress; special consideration must be given to those indirectly affected. Psychological interventions should account for realistic FoC and the impact of government-recommended health behaviours, as these factors are associated with distress in vulnerable groups and may extend beyond the pandemic. Future research should focus on longitudinal designs to monitor and better understand the clinical needs of those shielding, and those shielding others post-pandemic.

The relational calibration of fear

In this article, I consider how fear in contexts of crisis shapes and is shaped by agents' relationships. I survey a number of approaches to understanding fearing at the intersection of empirical psychology and philosophy, highlighting the extent to which interpersonal relationships are positioned as involved in processes of fearing, and establish what I take to insufficient attention paid by these approaches to the ways interpersonal relations shape the emotions we come to have. Contexts of acute crisis and uncertainty can involve rapidly adjusting practices of fearing in response to other agents, both those we trust and those we do not. I call for the development of a model of 'relational calibration' for understanding the complex interpersonal dynamics of fearing during crises, including in the context of the COVID-19 pandemic.

Use of an Online Platform to Evaluate the Impact of Social Distancing Measures on Psycho-Physical Well-Being in the COVID-19 Era

Background: The SARS-CoV-2 pandemic (Severe Acute Respiratory Syndrome Coronavirus 2) and the worldwide health crisis have significantly changed both people's habits and lifestyles. Most of the studies found in the literature were carried out on specific professional categories in the socio-health sector, taking into consideration psychological disorders in relation to work. The purpose of this study was to analyze the psychological impact on a portion of the normal population subjected to lockdown. Methods: A questionnaire was distributed in the period between 23 March 2020 and 18 May 2020 (during Italian lockdown) using an online platform. The scales GAD-7, IES-r, PHQ-9 and MANSA were used to investigate the level of anxiety, the presence of post-traumatic stress disorder, the severity of depression and the perceived quality of life, respectively. Results: Four hundred and eight Italian subjects responded. Females and younger people were more affected by anxiety and depression. Post-traumatic stress disorder affected about 40% of the population sample, significantly young people and women, thus attesting to an important psychopathological response. About one-fifth of the sample population recorded an unsatisfactory quality of life. Conclusions: The results highlight the need to set up preventive interventions (primary and secondary), trying to focus on the most fragile group of subjects from a psychosocial point of view, in order to obtain a significant reduction in psychophysical damage in terms of relapses and outcomes.

The role of alexithymia and perceived stress in mental health responses to COVID-19: A conditional process model

BACKGROUND

Little is known about the psychological mechanisms underlying the mental health problems related to the COVID-19 pandemic. Hypothetically, perceived stress and alexithymia may be factors involved in the mental distress response to the pandemic; however, this remains largely unstudied. This study aims to explore the moderating role of alexithymia and the moderated mediation effects of perceived stress on the mental health change due to the pandemic.

METHODS

The conditional process model was used to examine the moderated mediation. The sample consists of 659 parents from the FinnBrain Birth Cohort Study who completed the Toronto Alexithymia Scale (TAS-20) at 6 months after delivery, the Edinburgh Postnatal Depression Scale (EPDS) and the Symptom Checklist-90 (SCL-90) at 2 or 4 years postpartum between 2014 and 2019; and a questionnaire for pandemic events, a brief 4-item version of the Perceived Stress Scale (PSS-4) and the follow-up EPDS/SCL-90 in 2020 after 3 months from the outbreak of COVID-19 pandemic in Finland.

RESULTS

Alexithymia moderated the perceived stress-mediated relations between the pandemic events and the changes of depressive and anxiety symptoms through enhancing the detrimental effect of perceived stress on mental health.

LIMITATIONS

This study was mainly limited by the causality and generalizability of the findings.

CONCLUSIONS

Our findings indicate the moderated mediation effects of alexithymia and perceived stress on the psychological symptoms, which has implications for understanding how and when stressful situations translate to mental health problems, identifying vulnerable individuals, and tailoring preventive and psychotherapeutic interventions.

Pandemic Fatigue and Anxiety Sensitivity as Associated Factors With Posttraumatic Stress Symptoms Among University Students in South Korea During the Prolonged COVID-19 Pandemic

Objectives: The global impact of COVID-19 driven by new variants may add to the negative mental health consequences of the prolonged pandemic, including posttraumatic stress symptoms (PTSS). University students may be prone to develop a series of PTSS due to life plan disruptions as well as increased uncertainty caused by the pandemic. The purpose of this study was to assess the associations between pandemic fatigue, anxiety sensitivity (AS), and PTSS among university students in South Korea. Methods: Using convenience sampling, 400 students participated in this cross-sectional online survey. Descriptive statistics and linear mixed models were used to examine factors associated with PTSS. Results: About one-third (32.3%) of the participants reported clinically significant levels of PTSS. Multivariate analyses revealed that pandemic fatigue (β = 0.124, p < 0.001) and AS (β = 0.212, p < 0.001) were significantly associated with PTSS while controlling for other study variables. Conclusion: Young adults who feel more fatigue related to the COVID-19 pandemic and with high AS should be given access to mental health resources to better manage their mental health and reduce PTSS.

It's Time to be disgusting about COVID-19: Effect of disgust priming on COVID-19 public health compliance among liberals and conservatives

The COVID-19 pandemic is far from over, in part due to poor adoption of public health mitigation measures in the U.S. and the continued spread of the Delta and Omicron variants. Current public health messaging used in the U.S. could be improved to better combat mistrust about COVID-19 and its mitigation measures, especially vaccines. We propose that a disgust-inducing public health campaign will be more effective than current approaches, primarily among conservatives, who are both sensitive to moralized disgust and are less compliant with U.S. public health guidelines. Using a convenience sample across two studies (n = 1610), we found that presenting disgusting images related to the COVID-19 pandemic increased public health compliance more among conservatives than among liberals. Among unvaccinated conservative participants, disgusting images significantly increased willingness to be vaccinated compared to less disgusting images of COVID-19 or perks offered for COVID-19 vaccines. Using disgusting images for public health messaging has the potential to improve compliance among conservatives and accelerate the end of the COVID-19 pandemic in the U.S.

Is disgust proneness prospectively associated with influenza vaccine hesitancy and uptake?

Although various demographic and psychosocial factors have been identified as correlates of influenza vaccine hesitancy, factors that promote infectious disease avoidance, such as disgust proneness, have been rarely examined. In two large national U.S. samples (Ns = 475 and 1007), we investigated whether disgust proneness was associated with retrospective accounts of influenza vaccine uptake, influenza vaccine hesitancy, and eventual influenza vaccine uptake, while accounting for demographics and personality. Across both studies, greater age, higher education, working in healthcare, and greater disgust proneness were significantly related to greater likelihood of previously receiving an influenza vaccine. In Study 2, which was a year-long longitudinal project, disgust proneness prospectively predicted influenza vaccine hesitancy and eventual vaccine uptake during the 2020–2021 influenza season. Findings from this project expand our understanding of individual-level factors associated with influenza vaccine hesitancy and uptake, highlighting a psychological factor to be targeted in vaccine hesitancy interventions.

Longitudinal relationships between COVID-19 preventative behaviors and perceived vulnerability to disease

Engagement in infection-preventing behaviors (e.g., mask wearing) has become crucial in the context of the COVID-19 pandemic, and health-related anxiety may be an important determinant of individual compliance with recommended guidelines. However, little is known about transactional associations between health anxiety and preventative behaviors, particularly with respect to COVID-19. The present study aimed to longitudinally examine the links between preventative behaviors and both emotion-driven (Germ Aversion) and belief-based (Perceived Infectability) aspects of health anxiety during the COVID-19 pandemic. We hypothesized that greater health anxiety at Time 1 (early in the pandemic) would predict future compliance with preventative behaviors six months later. Two hundred and ninety-six adults (M/SD_age= 30.9/10.9 years, 42.2% female) completed two online assessments during the COVID-19 pandemic (Time 1 =June 2020; Time 2 =December 2020). Longitudinal cross-lagged analyses revealed that initial Germ Aversion predicted greater engagement in preventative behaviors at follow-up (β = 0.16; p = <.001), over and above initial engagement in such behaviors. Similarly, initial engagement in preventative behaviors predicted increases in Germ Aversion at follow-up (β = .23; p = <.001), over and above initial Germ Aversion. The present findings indicate that affect-driven aspects of health anxiety have a complex transactional relationship with engagement in behaviors aimed at curbing the spread of the COVID-19 pandemic. Clinical and public health implications are discussed.

The fear of COVID-19 and job insecurity impact on depression and anxiety: An empirical study in China in the COVID-19 pandemic aftermath

The employees' psychological health and resilience in times of emergency and general uncertainty was chosen due to the immense implications for economics, entrepreneurs, psychologists and psychiatrists, and policymakers. This study aims to provide an insight into uncertainty-induced anxiety and depression among Chinese employees in the aftermath of the COVID-19 outbreak. Analysis performed in the context of China in the COVID-19 pandemic aftermath is significant due to the universal nature of external shock impact on psychological welfare, applicable across nations and business sectors and in similar contexts. The statistical analysis was performed with SEM software AMOS version 23. The research model consisting of fear of COVID-19, job insecurity, anxiety, depression, was empirically tested. A purposive sampling technique was applied with the online questionnaire shared with employees in companies located in China. Respondents were working in educational services, information technology, engineering, electronics, and other sectors on white-collar jobs. The data collection was conducted from May to August 2020, in the aftermath of the COVID-19 pandemic in China. The research sample consisting of 283 respondents was used for analysis. Path analysis was performed, and standardized parameter estimates, standard errors, and p-values were calculated. The results indicate a positive and significant impact of job insecurity on depression and anxiety. Furthermore, results indicate that the fear of COVID-19 significantly impacts anxiety and depression but does not impact job insecurity. The findings can be used in a multidisciplinary effort to mitigate the psychological damage. Furthermore, they complement the ongoing epidemiological and scientific discourse on people's personal health and choice of coping.

The relationship between adolescent risk perception and emotions during the COVID-19: a short-term longitudinal study

This study explores the relationship between adolescents' perceptions of epidemic risk and their emotions through three follow-up surveys during the early stages of the COVID-19 pandemic on February 11th (T1), 18th (T2), and 25th (T3), 2020. Three hundred and four adolescents in different academic stages (junior high middle school, senior high middle school, and university) participated in the online survey, and cross-lag analysis was used to examine the causal relationship between epidemic risk perceptions and positive and negative emotions. The results found that the individual's positive emotions were significantly higher than the negative emotions in T1, T2 and T3. Cross-lag analysis found that for positive emotions, T2 positive emotions could negatively predict T3 epidemic risk perceptions, and T2 epidemic risk perceptions could negatively predict the individual's T3 positive emotions. For negative emotions, risk perceptions at T1 could positively predict negative emotions at T2, and at the same time, negative emotions at T1 could also positively predict epidemic risk perceptions at T2. This indicates that during the early stages of the COVID-19 pandemic, there was a causal relationship between the perceptions of epidemic risk and the emotions of adolescents, and this relationship had high stability among groups of different genders and academic stages.

Fear of Becoming Infected and Fear of Doing the Wrong Thing - Cross-Cultural Adaptation and Further Validation of the Multidimensional Assessment of COVID-19-Related Fears (MAC-RF)

Background

With the COVID-19 infection speeding around the world, many experience fear and anxiety. To detect those at risk of psychopathology and provide treatment, valid instruments are needed. The aim of this study was to cross-culturally validate the theory-based instrument Multidimensional Assessment of COVID-19-Related Fears (MAC-RF) in Croatian and to further examine the scale's validity by exploring its relationship with relevant constructs.

Method

A total of 477 participants completed an online survey during a rapid rise in new daily COVID-19 cases in Croatia and while new restrictions were being imposed.

Results

MAC-RF had a stronger association with health anxiety, cyberchondria, and anxiety sensitivity compared to depression, attesting to its convergent and divergent validity. However, a 2-factor structure was revealed in this sample: Fear of infection and Fear of using an inadequate strategy in dealing with pandemic. Fear of infection had a stronger association with health anxiety and COVID-19 anxiety and was a better predictor of COVID-19 related protective health behaviors. Fear of choosing an inadequate strategy had a stronger association with cyberchondria, fear of consequences of the epidemic on mental health, as well as financial consequences, and loss of civil liberties.

Conclusion

Fear of infection captures negative emotional states due to feared consequences on personal somatic health and the health of loved ones, while Fear of choosing an inadequate strategy in dealing with the pandemic reflects a metacognitive aspect. Treatments may have to target both aspects of COVID-19 related fear.

Unrealistic pessimism and obsessive-compulsive symptoms during the COVID-19 pandemic: Two longitudinal studies

Objective

Unrealistic pessimism (UP) is an aspect of overestimation of threat (OET) that has been associated with obsessive‐compulsive disorder/symptoms (OCD/OCS). During the COVID‐19 pandemic, UP may have played an important role in the course of OCD. To investigate the relationship, we conducted two longitudinal studies assuming that higher UP predicts an increase in OCS.

Method

In Study 1, we investigated UP in the general population (N = 1,184) at the start of the pandemic asking about overall vulnerability to infection with SARS‐CoV‐2 and UP regarding infection and outcome of severe illness. Further, OCS status (OCS+/−) was assessed at the start of the pandemic and 3 months later. In Study 2, we investigated UP in individuals with OCD (N = 268) regarding the likelihood of getting infected, recovering, or dying from an infection with SARS‐CoV‐2 at the start of the pandemic and re‐assessed OCS 3 months later.

Results

In Study 1, UP was higher in the OCS+ compared to the OCS− group, and estimates of a higher overall vulnerability for an infection predicted a decrease in OCS over time. UP regarding severe illness predicted an increase in symptoms over time. In Study 2, UP was found for a recovery and death after an infection with SARS‐CoV‐2, but not for infection itself.

Conclusions

Exaggeration of one’s personal vulnerability rather than OET per se seems pivotal in OCD, with UP being associated with OCD/OCS+ as well as a more negative course of symptomatology over the pandemic in a nonclinical sample.

Practitioner points

Unrealistic optimism, a bias common in healthy individuals, is thought to be a coping mechanism promoting well‐being in the face of danger or uncertainty.

The current study extends findings that its inversion, unrealistic pessimism, may play an important role in obsessive‐compulsive disorder and may also be involved in the development of the disorder.

This study highlights the importance that prevention programs during a pandemic should include targeting unrealistic pessimism.

Strategies and lessons learned from a longitudinal study to maximize recruitment in the midst of a global pandemic

The COVID-19 pandemic disrupted many usual processes for recruiting and enrolling research participants. We present our experience with electronic recruitment in a survey study investigating the impact of the COVID-19 pandemic on mental health. Adults (≥18 years) in communities served by Baylor Scott and White Health (BSWH) were recruited via patient portal messages sent to BSWH patients with confirmed/suspected COVID-19 as part of the "COVID-19 Digital Care Journey"; BSWH social media posts; other media; referral from other BSWH COVID-19 studies; and internal BSWH communications. Of 1279 enrolled participants, 996 (77.87%) were recruited via the Digital Care Journey and 124 (9.7%) via internal communications. The remaining strategies contributed <5% each. Social media and internal communications recruited larger proportions of those aged 18 to 34 and those with advanced degrees; other media, more racially diverse participants; and the Digital Care Journey and referral from other studies, predominantly participants positive for COVID-19. In terms of volume, the COVID-19 Digital Care Journey was the most successful strategy, particularly for individuals who had COVID-19. However, its dominance contributed to the overrepresentation of white, educated, and female participants. Thus, supplemental strategies to reach individuals not enrolled/engaging with the portal are necessary to achieve representativeness.

Emotional distress and coping strategies in COVID-19 anxiety

The present study aims to identify psychological factors affected by the COVID-19 pandemic given the information we have about reactions during previous pandemics, which documented features of anxiety, depression and post-traumatic stress disorder. We investigated the relationship between health anxiety, symptoms of depression, anxiety and stress, and coping mechanisms in the general population and among students. The study was conducted on Romanian population (n = 759), aged between 18-70 years old (M = 33.24), general population (n = 485), and students (n = 274). The results showed that the general population is more anxious when confronted with the new virus compared to students (t (757) = 1.902, p < .05, p = .029). Following the analysis of the hierarchical regression, the results revealed that when controlling the health anxiety variable, a high level of anxiety symptoms and stress, and a low level of depression symptoms could predict anxiety for COVID-19 (R 2  = .070, F change (3, 754) = 16.759, p ˂ .001). Also, we found that maladaptive strategies are the ones which explain the relationship between health anxiety and COVID-19-related anxiety (95% CI = .011 - .057). The results of this study bring extra knowledge and shed new light on the psychological aspects of the current sanitary crisis and contribute to the understanding of the way people relate to this disease.

Factors associated with general well-being among Lebanese adults: The role of emotional intelligence, fear of COVID, healthy lifestyle, coping strategies (avoidance and approach)

General well-being is best described as the state of mind that gives people happiness and satisfaction in life. This concept is influenced by behaviors and attitudes that individuals do on a daily basis. The purpose of this study was to understand how general well-being is correlated with other factors such as emotional intelligence, Covid-19-induced fear, healthy lifestyle, and coping strategies. This cross-sectional study was carried out between December 2020 and January 2021 during the COVID-19 pandemic when lockdown restrictions were implemented at different instances. A total of 470 individuals participated. The results of a linear regression, taking the general well-being schedule score as the dependent variable, showed that more avoidance coping (B = 1.05, t(459) =8.44, p < 0.001), higher healthy lifestyle scores (B = 0.45, t(459) = 5.45, p < 0.001), and more approach coping (B = 0.42, t(459) = 4.03, p < 0.001) were significantly associated with higher GWB schedule scores. Moreover, having more fear of COVID-19 (B = -0.62, t(459) = -5.09, p < 0.001) and female gender (B = -6.80, t(459) = -4.34, p < 0.001) were significantly associated with lower GWB schedule scores. To our knowledge, this is the first study in Lebanon to evaluate GWB and factors that predict it among the general population. Nevertheless, more comprehensive future studies with longitudinal designs, more diverse socio-demographic backgrounds of sampled population recruited via probability sampling, and more reliable and valid instruments utilized are warranted to confirm our findings and draw a more certain conclusion.

The Mediating Effect of Reassurance-Seeking Behavior on the Influence of Viral Anxiety and Depression on COVID-19 Obsession Among Medical Students

OBJECTIVES

Healthcare workers experienced great psychological burden due to the continuation of the COVID-19 pandemic. During the pandemic, medical healthcare workers experienced greater instances of insomnia, anxiety, depression, somatization, and obsessive-compulsive symptoms than the general population. This study aimed to explore the association between viral anxiety and obsession with COVID-19 among medical students with reassurance-seeking behavior as a mediator.

METHODS

In October 2021, an online survey was conducted among medical students at the University of Ulsan College of Medicine. The clinical characteristics of 162 participants and their responses to rating scales, including stress and anxiety to viral Epidemics-6 items (SAVE-6), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Patient Health Questionnaire-9 items (PHQ-9), and Obsession with COVID-19 scale were collected.

RESULTS

Medical students' obsession with COVID-19 was based on the PHQ-9 (β = 0.15, p = 0.01), SAVE-6 (β = 0.43, p < 0.001), and CRBS (β = 0.38, p < 0.001) scores (adjusted R² = 0.49, F = 39.9, p < 0.001). Mediation analysis showed that medical students' viral anxiety and depression directly influenced their obsession with COVID-19, and their reassurance-seeking behavior partially mediated the effects of depression or viral anxiety on obsession with COVID-19.

CONCLUSIONS

Medical students' viral anxiety and depression may affect their obsession with COVID-19, and reassurance-seeking behaviors may mediate this. Therefore, medical students should adopt adaptive coping strategies to prevent high levels of viral anxiety and recurrent reassurance-seeking behavior.

The Rise of Functional Tic-Like Behaviors: What Do the COVID-19 Pandemic and Social Media Have to Do With It? A Narrative Review

BACKGROUND

There has been a rise in explosive onset of tic-like behaviors during the COVID-19 pandemic. Historically, this is an uncommon phenomenology of functional movement disorders across all ages. Both the psychological burden of the pandemic and social media usage have been implicated in the rise of these tic-like behaviors.

METHODS

This paper provides a narrative review of the literature on chronic tic disorders, functional tics, and mass functional illness with particular focus on the key distinguishing features, role of social media, and the role of COVID-19.

RESULTS

The COVID-19 pandemic has profoundly affected the mental health of many individuals, including children, adolescents, and their caregivers. Implementation of lockdowns, lifestyle disruptions, school closures, and social distancing have driven a surge in social media and digital technology use. The combination of predisposing factors, the psychological burden of the COVID-19 pandemic, and social media are implicated in the rise and spread of tic-like behaviors; which may represent a modern-day form of mass functional illness. While many of the features overlap with functional tics, there are emerging distinctive features that are important to recognize. A more encompassing term, Functional Tic-Like Behaviors, is used to better reflect multiple contributing factors.

CONCLUSION

Knowledge of these differences is essential to mitigate downstream health effects and poor outcomes.

Adaptation and psychometric evaluation of Hungarian version of the Fear of COVID-19 Scale

Background

COVID-19 pandemic has had a global major healthcare, social and economic impact. In present study we aim to adapt the Fear of COVID-19 Scale to Hungarian.

Materials and methods

Forward-backward translation method was used to translate the English version of the scale to Hungarian. Participants were a convenience sample of 2175 university students and employees. The study was conducted between January 18^th and February 12^th 2021. The test battery included Hungarian versions of Fear of COVID-19 scale, short Beck Depression Inventory (BDI-H) and State-Trait Anxiety Inventory (STAI).

Results

The scale showed one-factor structure, the loadings on the factor were significant and strong (from .47 to .84). Internal consistency was very good (α = .84). Construct validity for the Fear of COVID-19 Scale was supported by significant and positive correlations with STAI (r = 0.402; p < 0.001) and BDI-H (r = 0.270; p < 0.001).

Conclusion

The Hungarian version of Fear of COVID-19 Scale is a reliable and valid tool in assessing fear of coronavirus.

Measuring COVID-19 related anxiety and obsession: Validation of the Coronavirus Anxiety Scale and the Obsession with COVID-19 Scale in a probability Chinese sample

BACKGROUND

With concern over the rise in mental health symptoms associated with the COVID-19 pandemic, the present study set out to address the absence of pandemic-specific screening tools for detecting those in Chinese societies who are at-risk for experiencing mental distress due to the pandemic; thus, its aim was to validate the Coronavirus Anxiety Scale (CAS) and Obsession with COVID-19 Scale (OCS) in Chinese adults.

METHODS

With a two-stage cluster random sampling method, we surveyed 1011 Chinese community-dwelling adults (38.8% men; 41.2 years old on average with an SD of 15.8) in June and July of 2020.

RESULTS

Our psychometric evaluation results showed that the Chinese version of CAS and OCS retained their original one-dimensional structure and demonstrated measurement invariance across genders. In line with validation studies of the CAS and OCS in other languages, subsequent analyses also provided support to our Chinese version with respect to their satisfactory internal consistency (α = .87 and .73, respectively), and good concurrent validity (i.e., positive associations with negative feelings, excessive time-consumption, subjective distress, and functioning impairment).

LIMITATIONS

Due to constraints of time and cross-sectional design, we only validated CAS and OCS among Chinese adults and did not evaluate their test-retest reliability nor predictive validity.

CONCLUSIONS

Considering the practical benefits of understanding the source of mental symptoms during the pandemic, we recommend the use of CAS and OCS in Chinese communities to facilitate early identification and intervention for those who require clinical attention due to their COVID-19 related anxiety and obsessive thoughts.

Are the concerns destroying mental health of college students?: A qualitative analysis portraying experiences amidst COVID-19 ambiguities

Coronavirus presenting an unforeseeable chain of events has exaggerated misery for students in India as they attracted the most detrimental experiences associated with lockdown restrictions leading to a shutdown of colleges as a preventive measure. The research endeavors to furnish a review of the overall hardships and psychological state of mind of college students and improvement in the implementation of policy decisions. Researchers conceptualize the newly discovered phenomenon by adopting grounded theory. Data from 256 newspaper articles, online articles and magazines have been gathered and converted into 256 separate files. To broaden the justification of research, social media analysis employing tweets, Facebook posts and Whatsapp messages are considered adding to the contributory prospects of the study. Compiled data is then refined through data mining technique. Triangulation approach amalgamating content analysis and thematic analysis has been deployed, thereby exploring the qualitative aspect of data gathering. Reviews from 31 students through telephonic conversation and 8 academic experts extended more accuracy to the research process. Findings administered academic disruptions with career concern, emotional suffering, financial concern, online learning, overseas injustice and psychological effects as the final themes representing various concerns experienced by college students. Hence, this work concludes with some constructive suggestions to deteriorate the amplified concerns.

When a nightmare comes true: Change in obsessive-compulsive disorder over the first months of the COVID-19 pandemic

The outbreak of the COVID-19 pandemic has particularly affected people with obsessive-compulsive disorder (OCD). Exacerbation of obsessive-compulsive symptoms (OCS) has been suspected for those with contamination-related OCD (C-OCD). However, the course of OCS over the ongoing pandemic remains unclear. We assessed 268 participants with OCD (n = 184 with C-OCD) in an online survey at the beginning of the pandemic in Germany, reassessing 179 participants (66.8%, 104 C-OCD) three months later. We assessed severity of OCD (OCI-R), depression (PHQ-9), experiential avoidance, as well as functional and dysfunctional beliefs. Overall, OCS and depressive symptoms did not substantially change over time. However, when people with and without C-OCD were compared, symptoms improved in patients without C-OCD (nC-OCD) but remained stable in patients with C-OCD over time. Symptom improvement was associated with male gender, higher initial OCI-R, and nC-OCD. Experiential avoidance and beliefs at the beginning of the pandemic did not generally predict change in OCS. People with OCD, particularly those with nC-OCD, showed tentative signs for signs of adapting, whereas distress in those with C-OCD remained at a high level, underlining the burden for these patients. Clinicians should be informed about how to maintain effective treatment for C-OCD during a pandemic.

Helping While Social Distancing: Pathogen Avoidance Motives Influence People's Helping Intentions during the COVID-19 Pandemic

The behavioral immune system (BIS) theory suggests that pathogen avoidance motives relate to greater behavioral avoidance against social interactions that pose potential risks of pathogen transmission. Based on the BIS theory, pathogen avoidance motives would decrease people’s helping behavior towards others. However, would pathogen avoidance motives decrease all types of helping behavior towards others during the Coronavirus disease 2019 (i.e., COVID-19) pandemic indiscriminately? In the present study, we conducted a within-subjects design to compare people’s helping intentions toward voluntary work with and without social contact. Specifically, participants (N = 1562) completed an online survey at the early stage of the COVID-19 pandemic in China measuring pathogen disgust sensitivity, state anxiety, and intentions to perform volunteer work with and without social contact. Results revealed that pathogen disgust sensitivity negatively predicted intentions to perform voluntary work with social contact yet had no influence on intentions to perform socially distanced voluntary work. Moreover, the effect of pathogen disgust sensitivity on socially distanced volunteering preference was mediated by the state anxiety people experienced during the pandemic. The findings have implications for understanding people’s helping behavior during the pandemic.

Increased Incidence of Functional (Psychogenic) Movement Disorders in Children and Adults Amid the COVID-19 Pandemic: A Cross-sectional Study

BACKGROUND AND OBJECTIVES

Functional (psychogenic) movement disorders (FMDs) are conditions in which affected patients develop abnormal movements that are incongruous with known, organic, movement disorders, often associated with psychological stressors.

METHODS

In this case series, electronic medical records of all patients who presented to our adult and pediatric tertiary care movement disorders clinics between March 1 and October 30, 2020, and during the same period in 2019 were reviewed. All patients diagnosed with functional (psychogenic) movement disorder were included if they satisfied diagnostic criteria.

RESULTS

Among 550 new patients referred for evaluation at our tertiary care movement disorders centers, 45 (8.2%) received a diagnosis of FMD; 75.6% were female, in comparison to the prior year during which time 665 new patients were evaluated and 5.1% were diagnosed with FMD. This represents a 60.1% increase (90.1% in pediatric cohort, 50.9% in adult cohort) in new patients diagnosed with FMD during the COVID-19 pandemic.

CONCLUSIONS

Within our patient population, there has been increased incidence of FMDs in the setting of the COVID-19 pandemic, possibly reflecting increased psychological and other stressors during this period.

"Touch Me If You Can!": Individual Differences in Disease Avoidance and Social Touch

The threat of diseases varies considerably among individuals, and it has been found to be linked to various proactive or reactive behaviors. In the present studies, we investigated the impact of individual differences in the perceived vulnerability to disease (PVD) on social touch before (Study 1) or during the coronavirus disease 2019 (COVID-19) pandemic (Study 2). We also investigated the influence of personality traits in the covariation between these two dimensions. We found that people who are the most disease-avoidant are also the most reluctant to touching or being touched by others (and this relationship holds when personality traits are taken into account). Interestingly, the association between PVD and social touch increased during the COVID-19 pandemic compared with a few months before. By showing that the fear of contamination has an association with social touch, the findings provide further evidence for the behavioral immune system ( Schaller and Park, 2011), a psychological system acting as a first line of defense against pathogens.

Predicting COVID-19-related anxiety: The role of obsessive-compulsive symptom dimensions, anxiety sensitivity, and body vigilance

The novel coronavirus disease (COVID-19), first detected in December of 2019 and declared a global pandemic in March of 2020, continues to pose a serious threat to public health and safety worldwide. Many individuals report anxiety in response to this threat, and at high levels, such anxiety can result in adverse mental health outcomes and maladaptive behavioral responses that have consequences for the health of communities more broadly. Predictors of excessive anxiety in response to COVID-19 are understudied. Accordingly, the present study examined psychological factors that predict more intense COVID-19-related anxiety. 438 community members completed measures assessing COVID-19-related anxiety as well as psychological variables hypothesized to predict anxious responding to the threat of COVID-19. As expected, obsessive-compulsive symptoms related to contamination, the fear of arousal-related body sensations (i.e., anxiety sensitivity), and body vigilance each predicted more severe anxiety related to the pandemic. Obsessive-compulsive symptoms related to responsibility for causing harm also emerged as a predictor. Study limitations and implications are discussed.

Predictors for COVID-19-related new-onset maladaptive behaviours in children presenting to a paediatric emergency department

BACKGROUND AND OBJECTIVE

The goal of the present study was to determine the incidence of new onset maladaptive behaviours in paediatric emergency department (PED) patients during the COVID-19 pandemic and to examine whether child and parent anxiety and parental health status were predictors for the new-onset of maladaptive behaviours.

METHODS

Participants included child-parent dyads seen in a PED following the state's issuance of mandatory stay-at-home orders on 19 March 2020. A total of 351 children age 0-25 years and 335 parents enrolled in the study. Parents provided baseline demographic data and completed standardised surveys that assessed aspects of parental and child anxiety and parental health, as well as child new-onset maladaptive behaviours. Children ≥8 years of age completed surveys that assessed child anxiety.

FINDINGS

Parents reported the new onset of maladaptive behaviours in children during the pandemic with frequencies up to 43%. Bivariate analysis identified predictors such as child anxiety (t(96) = -2.04, P = 0.044) as well as parental variables such as state anxiety (t(190) = -4.91, P < 0.001) and parental sensitivity to anxiety (t(243) = -3.19, P = 0.002). A logistic regression model identified parent mental health and COVID-19 anxiety as predictors of new onset maladaptive behaviours in children (X² (6) = 42.514, P < 0.001). Specifically, every unit change in parental anxiety of COVID-19 was associated with a unit increase in maladaptive behaviours in children.

CONCLUSIONS

We identified distinct parent and child-related factors that predicted new onset child maladaptive behaviours during the COVID-19 pandemic. The identification of such predictors may help clinicians to prevent maladaptive responses to the pandemic quarantine.