Anxiety effects on disaster precautionary behaviors: A multi-path cognitive model

Motivating Protective Behavior against COVID-19: Fear Versus Hope

OBJECTIVES

Based on protection motivation theory, we investigate how indicators of threat perception (perceived severity, perceived vulnerability, and fear arousal) and coping appraisal (hope) are associated with older people's motivation to engage in protective behavior after the outbreak of COVID-19.

METHODS

We use multivariate regression analyses with a sample of 40,282 individuals from 26 countries participating in the SHARE Corona Survey.

RESULTS

We find that 15% of all respondents stayed home completely-mainly the oldest and vulnerable people with prior health risk conditions. On average, older Europeans responded strongly to the recommended protective behavior measures (6 out of 7 measures adopted). Among the threat perception indicators, fear arousal is the main motivator for protective behavior, whereas the coping appraisal indicator hope shows an equally strong association.

DISCUSSION

Given the negative health effects of fear, our findings may help evaluate and revise governmental policy responses and communication strategies.

An assessment of nurses' perceived and actual household emergency preparedness

Nurses' household preparedness is critical if they are to avoid role conflict and report for duty during an emergency. To date, the alignment between nurses' perceived and actual household preparedness remains under examined. Investigating one of these variables in isolation fails to consider that perceived and actual household preparedness must be high and aligned. If misaligned, vulnerabilities could surface during emergencies, like concerns about family safety, potentially impacting a nurse's commitment to duty during a crisis, or nurses may lack the actual preparedness to continue working long hours during an emergency. An online questionnaire was distributed to registered nurses in Ireland. The questionnaire was informed by a review of the literature and captured nurses' perceived and actual household preparedness, attitudes towards and exposure to a range of emergencies, and pertinent demographic characteristics. The results showed a relationship between how nurses view their household preparedness and their actual preparedness. Regression analyses indicate that while there is an overlap, the factors associated with how prepared nurses think they are and how prepared they are can differ. This means that strategies to boost actual preparedness may differ from those needed to boost perceived preparedness. This finding underscores the importance of psychosocial preparedness. Feeling prepared is crucial as it can influence how one responds in an emergency. Considering both the perceived and actual aspects of household preparedness can lead to a more effective response during emergencies.

Perceived Threat of Disaster, Efficacy, and Psychological Distress Among Individuals with a Physical Disability: A Longitudinal Model

OBJECTIVE

Individuals with physical disabilities experience distress when faced with the threat of human-made and natural disasters, yet little is known about how to reduce that distress. This study used Protection Motivation Theory to longitudinally test the relationships between psychological distress and disaster-related cognitive appraisals, including perceived threat, emergency preparedness self-efficacy, and response efficacy, in a sample of individuals with physical disabilities.

METHODS

A nationwide convenience sample of 106 adults completed 2 surveys approximately 5 years apart. Structural equation modeling was used to assess effects of perceived threat, self-efficacy, and response efficacy on psychological distress across the 2 waves.

RESULTS

Our results suggest that the associations of proximal perceived threat and self-efficacy with psychological distress remain stable across time, while the effect of response efficacy is variable and may be more context-specific. Importantly, individuals who reported an increase in self-efficacy over time also reported (on average) a decrease in psychological distress.

CONCLUSIONS

In addition to broadening our understanding of factors related to psychological distress, these results have potentially important intervention implications; for example, to the extent that self-efficacy is a malleable construct, one way of reducing disaster-related psychological distress may be to increase an individual's self-efficacy.

The Effect of Temperament on the Association Between Pre-treatment Anxiety and Chemotherapy-Related Symptoms in Patients With Breast Cancer

OBJECTIVE

Pre-treatment anxiety (PA) before chemotherapy increases complaints of chemotherapy-related symptoms (CRS). The results on the association have been inconsistent, and the effect of temperament remains unclear. We aimed to determine whether PA is a risk factor for CRS and the effect of differing temperaments on CRS.

METHODS

This prospective study comprised 176 breast cancer patients awaiting adjuvant chemotherapy post-surgery. We assessed CRS, PA, and temperament using the MD Anderson Symptom Inventory (MDASI), the Hospital Anxiety and Depression Scale, and the short form of the Temperament and Character Inventory-Revised, respectively. The MDASI was re-administered three weeks after the first chemo-cycle.

RESULTS

PA showed weak positive correlation with several CRS after the first cycle; no CRS was significantly associated with PA when pre-treatment depressive symptoms and baseline CRS were adjusted in multiple regression analysis. Moderation model analysis indicated that the PA effect on several CRS, including pain, insomnia, anorexia, dry mouth, and vomiting, was moderated by harm avoidance (HA) but not by other temperament dimensions. In particular, PA was positively associated with CRS in patients with low HA.

CONCLUSION

The results in patients with low HA indicate that more attention to PA in patients with confident and optimistic temperaments is necessary.

Molecular actions of sex hormones in the brain and their potential treatment use in anxiety disorders

Anxiety disorders are one of the most prevalent mood disorders that can lead to impaired quality of life. Current treatment of anxiety disorders has various adverse effects, safety concerns, or restricted efficacy; therefore, novel therapeutic targets need to be studied. Sex steroid hormones (SSHs) play a crucial role in the formation of brain structures, including regions of the limbic system and prefrontal cortex during perinatal development. In the brain, SSHs have activational and organizational effects mediated by either intracellular or transmembrane G-protein coupled receptors. During perinatal developmental periods, the physiological concentrations of SSHs lead to the normal development of the brain; however, the early hormonal dysregulation could result in various anxiety diorders later in life. Sex differences in the prevalence of anxiety disorders suggest that SSHs might be implicated in their development. In this review, we discuss preclinical and clinical studies regarding the role of dysregulated SSHs signaling during early brain development that modifies the risk for anxiety disorders in a sex-specific manner in adulthood. Moreover, our aim is to summarize potential molecular mechanisms by which the SSHs may affect anxiety disorders in preclinical research. Finally, the potential effects of SSHs in the treatment of anxiety disorders are discussed.

Association Between Awareness, Perceived Severity, and Behavioral Control of COVID -19 With Self-Care and Anxiety in Pregnancy: A Cross-Sectional Study

COVID-19 pandemic has caused a tidal wave of anxiety and stress among Iranians, especially pregnant women. This study aimed to assess the association between knowledge, perceived severity, and controllability of COVID-19 with self-care and health anxiety specially in pregnancy. This cross-sectional study was performed on 440 pregnant women. Data were collected using demographic-obstetrics characteristics, as well as the questionnaires of knowledge, perceived severity, and perceived controllability of the COVID-19, health anxiety, and self-care. Self-care was positively correlated with knowledge, perceived severity, and perceived controllability of the COVID-19. Nonetheless, health anxiety had a significant and inverse association with knowledge and perceived controllability, while there was a positive and significant correlation between perceived severity and health anxiety. Based on linear regression, three variables of knowledge, perceived severity, and perceived controllability of the COVID-19 could explain 46.3 and 17.5% of variations in self-care and health anxiety, respectively. It is suggested that due to the critical importance of prenatal care, managers, and health-care providers promote the use of such methods as telehealth and home-based caregivers, especially in areas with inadequate access to health care. So, the pregnant women can be followed up and receive medical care devoid of any stress and anxiety.

Face Mask Use Among Commercial Drivers During the COVID-19 Pandemic in Accra, Ghana

The paper contributes to unravelling the perceptions of urban commercial drivers regarding their vulnerability to catching the SARS-CoV-2 virus while at work. It further examines how the perception of vulnerability influences personal use of face masks by drivers, as well as on their insistence on appropriate masking behaviour by other persons on-board public transport. Overcrowding and unsanitary conditions in informal public transport in Africa could facilitate the spread of the corona virus. However, the use of face masks, among other enhanced mitigation measures significantly contain and minimize the spread of the virus. Primary data, obtained through surveys at five major public transport terminals in Accra, was analysed and interpreted using the Health Belief Model as an explanatory framework. Results indicate that most drivers have a high vulnerability perception to Covid-19. It further emerged that older drivers, in particular, consistently wore face masks and insisted on other persons in their commercial vehicles to follow suit. Socio-demographic factors, and the need to ensure one's personal safety and those of loved ones were critical determinants of face mask use among surveyed drivers. The study thus recommends that public awareness campaigns should strategically focus attention on the younger generation of drivers (i.e. 18-39 years) who perceived themselves to be immune to the SARS-CoV-2 virus. Also, the collaborative efforts of state and non-state actors, like the transport operator unions, must be further strengthened if the gains made so far against Covid-19 is to be sustained.

Storms, Fires, and Bombs: Analyzing the Impact of Warning Message and Receiver Characteristics on Risk Perception in Different Hazards

In crisis communication, warning messages are key to prevent or mitigate damage by informing the public about impending risks and hazards. The present study explored the influence of hazard type, trait anxiety, and warning message on different components of risk perception. A survey examined 614 German participants (18-96 years, M = 31.64, 63.0% female) using a pre-post comparison. Participants were randomly allocated to one of five hazards (severe weather, act of violence, breakdown of emergency number, discovery of a World War II bomb, or major fire) for which they received a warning message. Four components of risk perception (perceived severity, anticipatory worry, anticipated emotions, and perceived likelihood) were measured before and after the receipt. Also, trait anxiety was assessed. Analyses of covariance of risk perception were calculated, examining the effect of warning message, trait anxiety, and hazard type while controlling for age, gender, and previous hazard experience. Results showed main effects of hazard type and trait anxiety on every component of risk perception, except for perceived likelihood. The receipt of a warning message led to a significant decrease in anticipated negative emotions. However, changes across components of risk perception, as well as hazards, were inconsistent, as perceived severity decreased while perceived likelihood and anticipatory worry increased. In addition, three interactional effects were found (perceived severity × hazard type, perceived severity × trait anxiety, and anticipated emotions × hazard type). The findings point toward differences in the processing of warning messages yet underline the importance of hazard type, as well as characteristics of the recipient.

Warning Messages in Crisis Communication: Risk Appraisal and Warning Compliance in Severe Weather, Violent Acts, and the COVID-19 Pandemic

Background

In crisis communication, warning messages are key to informing and galvanizing the public to prevent or mitigate damage. Therefore, this study examines how risk appraisal and individual characteristics influence the intention to comply with behavioral recommendations of a warning message regarding three hazard types: the COVID-19 pandemic, violent acts, and severe weather.

Methods

A cross-sectional survey examined 403 German participants from 18 to 89 years (M = 29.24; 72% female). Participants were allocated to one of three hazard types (COVID-19 pandemic, violent acts, severe weather) and presented with warning messages that were previously issued via an official warning app. Four components of risk appraisal—perceived severity (PS), anticipated negative emotions (AE), anticipatory worry (AW), and risk perception (RP)—were assessed before and after presenting the warning message. Path models were calculated to predict the intention to comply with the warning message, controlling for age, gender, and previous hazard experience.

Results

For the COVID-19 pandemic, higher age (β = 0.18) predicted warning compliance (R² = 0.05). AE (β = 0.20) predicted compliance in the case of violent acts (R² = 0.09). For severe weather, PS (β = 0.28), age (β = 0.29), and female gender (β = 0.34) lead to higher compliance (R² = 0.27). Changes across risk appraisal components were not consistent, as some facets decreased after the receipt of a warning message.

Discussion

Risk appraisal has shown a marginal yet differential influence on warning message compliance in different types of hazards. Regarding the COVID-19 pandemic, the impact of sociodemographic factors on compliance should be studied more intensively. Moreover, integrating intermediary variables, such as self-efficacy, is necessary.

Relationship between perception and anxiety about COVID-19 infection and risk behaviors for spreading infection: A national survey in Japan

Background

The novel corona virus infection (COVID-19) quickly became a pandemic state. Identifying characteristics of “possible super spreaders”, suggested as a dominant cause of rapid spreading transmission, will help us to design proper prevention strategies.

Methods

We conducted a nation-wide online survey to investigate the relationship of perception and anxiety levels about COVID-19 to the possible risk behaviors for spread of the virus in Japan. We recruited a total of 4,000 citizens, who responded to the questionnaire including several questions regarding the level of fear and anxiety about COVID-19, infection preventive behaviors and access to media with trust level about the virus as well as some demographic and socioeconomic data during March 27th and 28th, 2020.

Findings

Thirteen-point-three percent of the participants rated “1” on a nine-point Likert with respect to the knowledge about COVID-19. Ten-point-one percent and 11.7% presented no anxiety of being infected and transmission to others. Ten-point-eight percent showed no worry about symptomatic aggravation. Eight-point-one percent had no serious concern about expanding infection. The distribution of these items was highly correlated with each other. Participants with the low level of knowledge about COVID-19 were likely to less frequently access any information sources and neither trust them. They were less anxious about their health status, and less likely to put precautionary behaviors such as washing hands and avoiding crowded spaces, suggested by statistical analyses.

Interpretation

The present study suggests that it is greatly important to enlighten those have no concerns about this crisis of COVID-19 and modify their risk behavior via various ways, in order to prevent and control this viral pandemic.

Funding

This study was funded by the management grand provided to Chiba University Graduate School of Medicine and the Japan Society for the Promotion of Science KAKENHI grants.

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Lack of knowledge about COVID-19 is core trait of potential super spreaders, who occupy more than 10% of citizens.

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Super spreaders may be in a vicious circle of cognitive indifference, lack of information, and recurrent risky behaviors.

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Providing proper knowledge to indifferent individuals with any means is essential to resolve the pandemic of COVID-19.

Integrating mental health and disaster preparedness in intervention: a randomized controlled trial with earthquake and flood-affected communities in Haiti

BACKGROUND

Given the frequency of natural hazards in Haiti, disaster risk reduction is crucial. However, evidence suggests that many people exposed to prior disasters do not engage in disaster preparedness, even when they receive training and have adequate resources. This may be partially explained by a link between mental health symptoms and preparedness; however, these components are typically not integrated in intervention.

METHODS

The current study assesses effectiveness of an integrated mental health and disaster preparedness intervention. This group-based model was tested in three earthquake-exposed and flood-prone communities (N = 480), across three time points, using a randomized controlled trial design. The 3-day community-based intervention was culturally-adapted, facilitated by trained Haitian lay mental health workers, and focused on enhancing disaster preparedness, reducing mental health symptoms, and fostering community cohesion.

RESULTS

Consistent with hypotheses, the intervention increased disaster preparedness, reduced symptoms associated with depression, post-traumatic stress disorder, anxiety, and functional impairment, and increased peer-based help-giving and help-seeking. Mediation models indicated support for the underlying theoretical model, such that the effect of the intervention on preparedness was mediated by mental health, and that effects on mental health were likewise mediated by preparedness.

CONCLUSIONS

The community-based mental health-integrated disaster preparedness intervention is effective in improving mental health and preparedness among community members in Haiti vulnerable to natural hazards. This brief intervention has the potential to be scaled up for use with other communities vulnerable to earthquakes, seasonal flooding, and other natural hazards.