The psychological typhoon eye effect during the COVID-19 outbreak in China: the role of coping efficacy and perceived threat

Mixed methods examination of risk perception on vaccination intentions: The perspective of doctor-patient communication

AIM

From the perspective of doctor-patient communication, this research used multiple methods combined natural language processing (NLP), a cross-sectional survey and an online experiment to investigated how risk perception influenced people's vaccination intention.

METHODS

In Study 1, we used Python to crawl 335,045 comments about COVID-19 vaccine published in a social media platform Sina Weibo (equivalent of Twitter in China) from 31 December 2020 to 31 December 2021. Text analysis and sentiment analysis was used to examine how vaccination intention, as measured by linguistic features from the LIWC dictionary, changed with individuals' perceptions of pandemic risk. In Study 2, we adopted a cross-sectional questionnaire survey to further test the relation of risk perception, vaccination intention, trust in physicians, and perceived medical recommendations in a Chinese sample (n = 386). In Study 3, we conducted an online experiment where we recruited 127 participants with high trust in physicians and 127 participants with low trust, and subsequently randomly allocated them into one of three conditions: control, rational recommendation, or perceptual recommendation.

RESULTS

Text and sentiment analysis revealed that the use of negative words towards COVID-19 vaccine had a significant decrease at high (vs. low) risk perception level time (Study 1). Trust in physicians mediated the effect of risk perception on vaccination intention and this effect was reinforced for participants with low (vs. high) level of perceived medical recommendation (Study 2), especially for the rational (vs. perceptual) recommendation condition (Study 3).

CONCLUSION

Risk perception increased vaccination intention through the mediating effect of trust in physicians and the moderating effect of perceived medical recommendations. Rational (vs. perceptual) recommendation is more effective in increasing intention to get vaccinated in people with low trust in physicians.

Latent profile and network analysis of risk perception among a sample of Chinese university students during the COVID-19 pandemic: a cross-sectional and longitudinal study

Background

The risk perception of contracting COVID-19 is an important topic for assessing and predicting COVID-19 infection and health education during the pandemic. However, studies that use latent profiles and network analysis together to measure the risk perception of COVID-19 are rare. Therefore, this study combined latent profile analysis and network analysis to measure risk perception toward COVID-19 among Chinese university students through a cross-sectional and longitudinal study.

Methods

A sample of 1,837 Chinese university students (735 males, 40%) completed the cross-sectional study with an eight-item risk perception questionnaire in January 2020, while 334 Chinese university students (111 males, 33.2%) completed the longitudinal study at three time points.

Results

A two-class model including a low risk perception class (n = 1,005, 54.7%) and a high risk perception class (n = 832, 45.3%) was selected for the cross-sectional study. Nodes rp6 ("Average people have chances of contracting COVID-19'') and rp7 ("Average people worry about catching COVID-19") had the strongest edge intensity (r = 0.491), while node rp5 ("The COVID-19 outbreak affects the whole country") had the highest strength centrality in the cross-sectional study. The risk perception of contracting COVID-19 decreased continuously at the three time points. Moreover, the network structures and global strengths had no significant differences in the longitudinal study.

Conclusions

The risk perception of contracting COVID-19 decreased continually during the COVID-19 pandemic, which indicated the importance of cultural influence and effective government management in China. In addition, university students displayed strong trust and confidence in the government's ability to fight COVID-19. The results indicate that the government should take strong measures to prevent and intervene in various risks and reinforce the public's trust through positive media communications.

Coping efficacy is associated with the domain specificity in risk-taking behaviors during the COVID-19 pandemic

The current study is to explore the associations between the threat to life and risk-taking behaviors across different domains during the coronavirus disease (COVID-19), and the role of the perceived threat and coping efficacy in these associations based on protection motivation theory. This study conducted an online survey on 2983 participants from 30 provinces in China. It found that people's risk-taking behaviors in the wake of the COVID-19 pandemic could be divided into stimulating risk-taking (SRT) behaviors and instrumental risk-taking (IRT) behaviors. The exposure level to the COVID-19 pandemic was negatively related to SRT behaviors in natural/physical, gambling, safety, moral, and reproductive domains, but not related to IRT behaviors in financial and corporation/competition domains. Two parallel routes were found in domain-specific risk-taking behaviors when people were faced with a life-threatening epidemic. Specifically, perceived threat consistently mediated the positive relationship between exposure level and risk-taking behaviors across domains. In contrast, coping efficacy mediated the negative relationship between exposure level and SRT behaviors but positive associations with IRT behaviors. These findings indicated that coping efficacy, rather than perceived threat is the factor that explains the people's domain-specific risk-taking behaviors in the context of the epidemic. The study holds implications for emergency policy-making that targets disaster risk reduction by increasing the public coping efficacy, which could prevent unnecessary SRT behaviors and improve necessary IRT behaviors in business and investment for economic recoveries.

How Health-Related Misinformation Spreads Across the Internet: Evidence for the "Typhoon Eye" Effect

Online health-related misinformation has become a major problem in society and in-depth research is needed to understand its propagation patterns and underlying mechanisms. This study proposes a psychological typhoon eye effect to understand how health-related misinformation spreads during the pandemic using two national studies. In Study 1, we collected online search data from the United States and China to explore the relationship between the physical distance from the epicenter and the spread of health-related misinformation. Two common pieces of health-related misinformation were examined: "Microwaves kill coronavirus" in the United States and "Taking a hot bath can prevent against COVID-19" in China. Our results indicated a "typhoon eye effect" in the spread of two actual pieces of health-related misinformation using online data from the United States and China. In Study 2, we fabricated a piece of health-related misinformation, "Wash Clothes with Salt Water to Block Infection," and measured the spread behavior and perceived credibility of the misinformation. Again, we observed a typhoon eye effect on the spread behavior as well as the perceived credibility of health-related misinformation among people with limited education. In addition, based on the stimulus-organism-response theory, perceived credibility could serve as a mediator in the relationship between physical distance from the epicenter and the spread of health-related misinformation. Our results highlight the importance of psychological approaches to understanding the propagation patterns of health-related misinformation. The present findings provide a new perspective for development of prevention and control strategies to reduce the spread of health-related misinformation during pandemics.

The Association of Social Emotions, Perceived Efficiency, Transparency of the Government, Concerns about COVID-19, and Confidence in Fighting the Pandemic under the Week-Long Lockdown in Shenzhen, China

The outbreak and spread of the COVID-19 pandemic have had a far-reaching impact. The present study investigated the factors primarily affecting the execution of the control measures, including social emotions, concerns about the pandemic, perceived efficiency, transparency of the government in publishing the pandemic-related information, and confidence in fighting the pandemic. Specifically, we examined the differences in these factors across four areas (i.e., lockdown area, control area, prevention area, and safe area) according to different COVID control measures under the week-long lockdown in Shenzhen. We found that social emotions, concerns about the pandemic, perceived efficiency of the government, and confidence in fighting the pandemic were more negative in the lockdown area than that in other areas. More importantly, after controlling for areas and education level of participants, the emotion of optimism, concerns about the COVID-19 pandemic, perceived efficiency, and perceived transparency of the government in releasing COVID-19 relevant information positively predicted confidence in fighting the pandemic, while anger negatively predicted confidence in fighting the pandemic. Therefore, the government and communities could make efforts at effective communication and find innovative approaches to make individuals (especially in the lockdown area) maintain social connections, reduce negative emotions, and enhance confidence in combating the pandemic.

Children's Mental Health During the First Two Years of the COVID-19 Pandemic: Burden, Risk Factors and Posttraumatic Growth - A Mixed-Methods Parents' Perspective

The COVID-19 pandemic and the accompanying containment measures such as physical distancing and school closures led to major changes in children's everyday lives. By means of a mixed-methods study, the "Tyrolean COVID-19 Children's Study" investigated the effects of the pandemic and factors influencing mental health and health-related quality of life of North Tyrolean (Austria) and South Tyrolean (Italy) children aged 3-13 years. Parents filled out N = 2,691 online questionnaires (951 preschool children: 3-6 years; 1,740 schoolchildren: 7-13 years) at four measurement time points (March 2020, December 2020, June 2021, December 2021). For both age groups, children's mental health outcomes (internalising problems, posttraumatic stress symptoms) were worse in December 2021 (t4) than children's mental health outcomes in March 2020 (t1). With regard to aggressive behaviour, this difference was only found among schoolchildren. Thematic analysis of an open ended, written question revealed the following positive changes in children during the Corona crisis: (1) the importance of intra- and extra-familial relationships, (2) new competences and experiences, (3) values and virtues, (4) use of time, and (5) family strength. Using multilevel modelling, threat experience, economic disruption, and perceived posttraumatic growth were shown to be the strongest predictors of all outcomes. Additionally, male gender was shown to be a predictor of aggressive behaviour. In terms of age, schoolchildren showed more internalising problems, aggressive behaviour, and threat experience than preschool children. With regard to time, parents in December 2021 reported more threat experience in older children and less perceived posttraumatic growth in both older and younger children, than parents at the beginning of the pandemic. Targeted support for vulnerable children may prevent longer-term development of psychopathologies and contribute to society's psychosocial resilience in the current COVID-19 pandemic. Moreover, sustainable promotion of children's posttraumatic growth can also contribute to children's mental health and could even offer a chance to turn the crisis into an opportunity.

Research of the Changes in the Psychological Status of Chinese University Students and the Influencing Factors During the COVID-19 Pandemic

Background

Psychological dynamics of college students have changed during the COVID-19 outbreak but little research has been done in this area. The purpose of this study is to investigate the dynamic changes in the mental health status of college students since the outbreak of the COVID-19 pandemic 1 year and the influencing factors.

Methods

The research period was from February 2020 to August 2021. 384 college students were analyzed three times during this period on the recognition and psychological state of the pandemic.

Results

During the period from February 2020 to August 2021, in general, the positive scores rose from 20.79 to 23.46, while the negative scores dropped from 17.41 to 14.00. The regression analysis results on the influencing factors showed the degree of recognition of the pandemic is all significant in the three phases (p < 0.05).

Conclusion

With the effective control of the pandemic, the mental state of the students showed a slight improvement in the environment of sporadic cases. Behavior has a partial mediating effect between the source of fear and psychological changes. Correct behavior guidance can effectively reduce the psychological changes caused by college students’ fear.

Exploring the effects of spatial distance on public perception of waste-to-energy incineration projects

The spatial distance of residents from potentially harmful facilities plays a vital role in shaping their perceptions of the facilities. Based on environmental psychology theories, such as the ripple effect, psychological typhoon eye effect, and marginal zone effect, two waste-to-energy (WTE) incineration plants in China's Zhejiang province are used as case studies to understand peoples' perceptions. Following a questionnaire survey of local residents, the results of a one-way ANOVA indicate a low acceptance of incinerators and a high level of perceived risk; the impact of spatial distance on the local residents' level of perceived risk correspond to the marginal zone effect; and the perception of economic benefits, trust, fairness, and acceptance of WTE incinerators have a ripple effect. Furthermore, the impact of spatial distance is effectively eliminated or alleviated by a range of community engagement approvals and various forms of economic compensation. These findings enrich the knowledge system related to environmental psychology research on NIMBY infrastructure projects and contribute toward better understanding of public psychology in order to provide a future reference for more efficient decision-making models.

Meta-Regression on the Heterogenous Factors Contributing to the Prevalence of Mental Health Symptoms During the COVID-19 Crisis Among Healthcare Workers

Objective

This paper used meta-regression to analyze the heterogenous factors contributing to the prevalence rate of mental health symptoms of the general and frontline healthcare workers (HCWs) in China under the COVID-19 crisis.

Method

We systematically searched PubMed, Embase, Web of Science, and Medrxiv and pooled data using random-effects meta-analyses to estimate the prevalence rates, and ran meta-regression to tease out the key sources of the heterogeneity.

Results

The meta-regression results uncovered several predictors of the heterogeneity in prevalence rates among published studies, including severity (e.g., above severe vs. above moderate, p < 0.01; above moderate vs. above mild, p < 0.01), type of mental symptoms (PTSD vs. anxiety, p = 0.04), population (frontline vs. general HCWs, p < 0.01), sampling location (Wuhan vs. Non-Wuhan, p = 0.04), and study quality (p = 0.04).

Conclusion

The meta-regression findings provide evidence on the factors contributing to the prevalence rate of mental health symptoms of the general and frontline healthcare workers (HCWs) to guide future research and evidence-based medicine in several specific directions.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=220592, identifier: CRD42020220592.

Bull's eye or typhoon eye? Psychological distress and associated factors in Wuhan and surrounding areas during the COVID-19 pandemic

The COVID-19 pandemic caused significant psychological consequences among the public, especially for people in the epicenter. This study examined the 'bull's eye' model by comparing the level of psychological distress and the effect of different stressors in Wuhan (the original epicenter) with that in the surrounding areas in Hubei Province during the pandemic. Data were obtained from a cross-national survey of 10 478 respondents between the ages of 18 and 80 years in Hubei Province during the peak of the pandemic. Results of the ordinary least squares regression models showed that Wuhan residents experienced more psychological distress than those in the surrounding areas. Social and economic problems caused by the pandemic, risk exposure, perceived discrimination, and information-seeking behaviors were positively associated with distress. Social assistance was negatively associated with distress. Findings were consistent with the bull's eye model by revealing both a higher level of psychological distress and a stronger effect of stressors among the Wuhan residents than with those in low-risk areas. Thus, policymakers and psychological workers should provide adequate psychological services in high-risk areas. Lowering risk exposure, reducing discrimination against people in the epicenter, and improving information quality are essential to alleviate their psychological distress.

Increases in Anxiety and Depression During COVID-19: A Large Longitudinal Study From China

Although accumulating evidence suggests the COVID-19 pandemic is associated with costs in mental health, the development of students' mental health, including the change from their previous levels of depression and anxiety and the factors associated with this change, has not been well-studied. The present study investigates changes in students' anxiety and depression from before the pandemic to during the lockdown and identifies factors that are associated with these changes. 14,769 university students participated in a longitudinal study with two time points with a 6-month interval. Students completed the Anxiety and Depression subscales of the Symptom Checklist 90 (SCL-90) before the COVID-19 outbreak (October 2020, Time 1), and the Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) during the pandemic (April 2020, Time 2). The prevalence of anxiety and depression symptoms were 1.44 and 1.46% at Time 1, and 4.06 and 22.09% at Time 2, respectively, showing a 181.94% increase in anxiety and a 1413.01% increase in depression. Furthermore, the increases in anxiety and depression from pre-pandemic levels were associated with students' gender and the severity of the pandemic in the province where they resided. This study contributes to the gap in knowledge regarding changes in students' mental health in response to the pandemic and the role of local factors in these changes. Implications for gender and the Typhoon Eye effect are discussed.

No significant association of repeated messages with changes in health compliance in the COVID-19 pandemic: a registered report on the extended parallel process model

When people are confronted with health proposals during the coronavirus disease 2019 (COVID-19) pandemic, it has been suggested that fear of COVID-19 can serve protective functions and ensure public health compliance. However, health proposal repetition and its perceived efficacy also influence the behavior intention toward the proposal, which has not yet been confirmed in the COVID-19 context. The present study examined whether the extended parallel process model (EPPM) could be generalized to a naturalistic context like the COVID-19 pandemic. Additionally, we explored how repetition of a health proposal is involved with the EPPM. In this study, two groups of participants were exposed to the same health proposal related to COVID-19, where one group was exposed once and another group twice. Participants then filled out a questionnaire consisting of items concerning behavior intention and adapted from the Risk Behavior Diagnosis Scale. Structural equation modeling was used to determine the multivariate associations between the variables. Although the results showed that behavior intention is predicted by perceived efficacy, no significant influence of perceived threat was detected. Furthermore, no significant effect of repetition was found toward either response efficacy or perceived susceptibility. These findings indicate that to promote health compliance during the COVID-19 pandemic, it is more efficient to focus on health proposals’ perceived efficacy rather than the disease’s perceived threat. For future health communication research, the present study suggests improved analysis strategies and repeated manipulation of messages.

How perceived threat of COVID-19 related to aggressive tendencies during the pandemic in Hubei Province and other regions of China: Mediators and moderators

During the COVID-19 pandemic in early 2020, domestic violence, interpersonal conflicts, and cyberbullying have risen sharply in China. We speculate that the perceived threat of COVID-19 is related to a general, non-target-specific aggressive tendency during the pandemic. We surveyed 1556 Chinese people in April 2020 (757 people in Hubei Province, the pandemic epicenter in China, and 799 in other regions of China where the pandemic is relatively not severe). A multiple-group structural equation modeling analysis found significant total effects between perceived threat of COVID-19 and aggressive tendencies during the pandemic in both regional groups, and the effect between them was mainly achieved through the mediating roles of sense of control and powerlessness during the pandemic. For all participants, negative coping strategies significantly aggravated the association between perceived threat of COVID-19 and aggressive tendencies during the pandemic, but the buffers were different across regions of outbreak severity. For participants in other regions where the pandemic is relatively not severe, positive coping strategies could mitigate the association between perceived threat of COVID-19 and aggressions. However, for participants in Hubei Province, the epicenter of China's pandemic, higher life satisfaction was more effective in buffering. These findings extend the possible consequences of the perceived COVID-19 threat and suggest that improving the life satisfaction of residents in areas with severe outbreaks is more effective in mitigating the adverse effects of COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-021-01792-7.

The Prevalence of Psychological Status During the COVID-19 Epidemic in China: A Systemic Review and Meta-Analysis

The COVID-19 is creating panic among people around the world and is causing a huge public mental health crisis. Large numbers of observational studies focused on the prevalence of psychological problems during the COVID-19 pandemic were published. It is essential to conduct a meta-analysis of the prevalence of different psychological statuses to insight the psychological reactions of general population during the COVID-19 epidemic in China. Sixty six observational studies about the psychological statuses of people during the COVID-19 were included, searching up to 1 December 2020. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) was used to evaluate the quality of the included studies. OpenMeta[Analyst] was used for the data analysis. High prevalence of acute stress and fear symptoms were observed in the early period of the epidemic. Additionally, anxiety and depression symptoms continued at a high prevalence rate during the epidemic. It should alert the lasting mental health problems and the risk of post-traumatic stress disorder and other mental disorders. Systematic Review Registration: PROSPERO CRD 42020171485.

Typhoon eye effect versus ripple effect: the role of family size on mental health during the COVID-19 pandemic in Pakistan

BACKGROUND

The recent outbreak of COVID-19 has impacted adversely upon the mental health of millions of people worldwide. Impacts on the mental health conditions and the associated predictors relating to adults in Pakistan, the fifth most populous country in the world, during the COVID-19 remain understudied. Our aim was to investigate distress, anxiety, and overall mental health and their associated predictors among Pakistani adults in this pandemic. We specifically examine mental health issues based on the distance from the epicenter, (a predictor that has revealed opposing evidence in other countries) based on the theories of typhoon eye effect and ripple effect. The sample consisted of 601 adults who were surveyed online about 2.5 months into the outbreak across Pakistan with varying distances from the epicenter of COVID-19 of Karachi.

RESULTS

The results showed that 9.2 and 19.0% of the participants surpassed the cut-off criteria for distress and anxiety disorders, respectively. Overall, the distance from the epicenter positively predicted the mental health of adults in Pakistan, and family size negatively moderated this effect. The distance from the epicenter negatively predicted distress and anxiety disorders for adults in large families, which are quite common in Pakistan.

CONCLUSION

The evidence of the study interestingly finds that the prediction of the mental health of people by their distance from the epicenter depends on family size. The evidence of this study can help to provide initial indicators for mental health care providers to screen vulnerable groups in Pakistan, a populous country that continues struggling to cope with the COVID-19 pandemic.