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Chung S, Song K, Günlü A. The Effect of Psychological Inflexibility on Social-Distancing Phobia Mediated by Preoccupation With Sleep and Intolerance of Uncertainty in the Elderly Population During the COVID-19 Pandemic. Psychiatry Investig 2024; 21:151-158. [PMID: 38321888 PMCID: PMC10910166 DOI: 10.30773/pi.2023.0326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/03/2023] [Accepted: 11/15/2023] [Indexed: 02/08/2024] Open
Abstract
OBJECTIVE The aim of this study was to explore whether psychological inflexibility in the elderly population is related to social-distancing phobia, and examine whether their viral anxiety, preoccupation with sleep, or intolerance of uncertainty may mediate the relationship. METHODS Among the elderly population aged ≥65 in Korea, we conducted an anonymous online survey during January and February 2023. We collected the responses of 300 participants, collected demographic information, and symptoms using rating scales such as the Social-Distancing Phobia scale, Stress and Anxiety to Viral Epidemics-6 items (SAVE-6), Intolerance of Uncertainty Scale-12 (IUS-12), Acceptance and Action Questionnaire-II (AAQ-II), and Glasgow Sleep Effort Scale (GSES). RESULTS Social-distancing phobia was expected by the SAVE-6 (β=0.34, p<0.001), IUS-12 (β=0.18, p=0.003), and GSES (β=0.18, p= 0.001) in the linear regression analysis. In the mediation analysis, psychological inflexibility did not directly influence social-distancing phobia. However, viral anxiety, intolerance of uncertainty, or preoccupation with sleep completely mediated the influence of psychological inflexibility on social-distancing phobia among elderly population. CONCLUSION The management of psychological inflexibility, intolerance of uncertainty, or preoccupation with sleep needs to be considered when designing interventions to address social-distancing phobia in elderly populations in future pandemics.
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Affiliation(s)
- Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kayoung Song
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of Korea
| | - Aykut Günlü
- Department of Child Care and Youth Services, Pamukkale University, Denizli, Turkey
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Hammoudi SF, Ahmed O, An H, Hong Y, Ahn MH, Chung S. Adherence to Physical Distancing and Health Beliefs About COVID-19 Among Patients With Cancer. J Korean Med Sci 2023; 38:e336. [PMID: 37935163 PMCID: PMC10627725 DOI: 10.3346/jkms.2023.38.e336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 07/21/2023] [Indexed: 11/09/2023] Open
Abstract
BACKGROUND This study aimed to validate questionnaires on adherence to physical distancing and health beliefs about coronavirus disease 2019 (COVID-19) among patients with cancer and explore their interaction with depression or viral anxiety among them. METHODS Through an online survey, data from 154 cancer patients (female: 82.5%, breast cancer: 66.2%, current cancer treatment, presence: 65.6%) were collected from March to June 2022. The survey gathered responses to questionnaires on adherence to physical distancing, health beliefs about COVID-19, perceived social norms, Stress and Anxiety to Viral Epidemics-6 items, and Patient Health Questionnaire-2. Confirmatory factor analysis (CFA) for construct validity and structural equation model (SEM) were performed. RESULTS The CFA showed a good model fit for adherence to physical distancing (comparative fit index [CFI] = 1.000, Tucker-Lewis index [TLI] = 0.930, root-mean-square-error of approximation [RMSEA] = 0.000, and standardized root-mean-square residual [SRMR] = 0.050) and a satisfactory model fit for health beliefs about COVID-19 (CFI = 0.978, TLI = 0.971, RMSEA = 0.061, and SRMR = 0.089). Through SEM, we found that personal injunctive norms were the main mediators linking health beliefs with physical distancing in patients with cancer. Depression also mediated the effects of viral anxiety and perceived severity on physical distancing (χ² = 20.073, df = 15, P = 0.169; CFI = 0.984; RMSEA = 0.047). CONCLUSION The questionnaires are reliable and valid. Patients with cancer may be able to adhere to physical distancing by addressing perceived severity, viral anxiety, perceived benefits, self-efficacy, perceived barriers, as well as personal injunctive norms.
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Affiliation(s)
| | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Hoyoung An
- Department of Psychiatry, Keyo Hospital, Uiwang, Korea
| | - Youjin Hong
- Department of Psychiatry, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Myung Hee Ahn
- Division of Psychiatry, Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Cho E, Hong J, Kim H, Park CHK, Hong Y, Park J, Jun JY, Chung S. Influence of Intolerance of Uncertainty on Preoccupation With Coronavirus Disease 2019 Among Frontline Nursing Professionals: Mediating Role of Reassurance-Seeking Behavior and Adherence to Physical Distancing. J Korean Med Sci 2023; 38:e282. [PMID: 37698207 PMCID: PMC10497351 DOI: 10.3346/jkms.2023.38.e282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Accepted: 06/25/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND This study investigated the relationship between preoccupation with coronavirus disease 2019 (COVID-19), reassurance-seeking behavior, viral anxiety, intolerance of uncertainty, and adherence to physical distancing among frontline nursing professionals working in COVID-19 inpatient wards. Additionally, the study aimed to determine whether the commitment to physical distancing mediates the influence of intolerance of uncertainty on viral anxiety. METHODS Frontline healthcare professionals working in the COVID-19 inpatient wards at three tertiary-level affiliated hospitals in Korea were surveyed between April 7 and 26, 2022. The survey included scales-such as the Obsession with COVID-19 Scale, Coronavirus Reassurance-Seeking Behaviors Scale, Fear of COVID-19 Scale, and Intolerance of Uncertainty Scale-12 and a questionnaire on adherence to physical distancing. A total of 256 responses were analyzed after excluding inappropriate or incomplete responses. RESULTS Pearson's correlation analysis found that age was significantly associated with the Obsession with COVID-19 Scale (r = -0.12, P < 0.05) and adherence to physical distancing (r = 0.27, P < 0.01). Linear regression analysis ascertained that age (β = -0.07, P = 0.002), Coronavirus Reassurance-Seeking Behaviors Scale (β = 0.35, P < 0.001), and Fear of COVID-19 Scale (β = 0.24, P < 0.001) were predictors of obsession with COVID-19 (Adjusted R² = 0.60, F = 78.1, P < 0.001). The indirect pathway by mediation analysis showed that reassurance-seeking and viral anxiety mediated the effect of intolerance of uncertainty on the preoccupation with COVID-19. CONCLUSION During the pandemic, there may be a strong association between reassurance-seeking behavior, viral anxiety, and a heightened preoccupation with COVID-19 among frontline healthcare workers. Thus, from the early stages of infectious disease, a psychological support team for medical staff responding to the disease should be established, and periodic evaluations should be conducted to identify high-risk groups.
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Affiliation(s)
- Eulah Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jihoon Hong
- University of Ulsan College of Medicine, Seoul, Korea
| | - Harin Kim
- University of Ulsan College of Medicine, Seoul, Korea
| | - C Hyung Keun Park
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Youjin Hong
- Department of Psychiatry, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Jangho Park
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Jin Yong Jun
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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Chung S, Lee HS, Jang S, Shin YW, Kim JH, Jun JY. Pandemic Grief Reaction and Intolerance of Uncertainty on the Cognitive-Behavioral Model of COVID-Related Hypochondriasis Among Firefighters. Psychiatry Investig 2023; 20:826-833. [PMID: 37794664 PMCID: PMC10555506 DOI: 10.30773/pi.2023.0165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 06/18/2023] [Indexed: 10/06/2023] Open
Abstract
OBJECTIVE This study aimed to explore the feasibility of cognitive-behavioral model hypochondriasis regarding coronavirus disease-2019 (COVID-19) among firefighters. In addition, we examined the possible role of their grief reaction and intolerance of uncertainty in the model of COVID-related hypochondriasis. METHODS An anonymous online survey was done on October 27-28, 2022, among firefighters who witnessed people's death. Demographic characteristics were collected, and their psychological states were assessed using rating scales such as the Obsession with COVID-19 Scale (OCS), Coronavirus Reassurance-Seeking Behaviors Scale (CRBS), Fear of COVID-19 Scale (FCV-19S), Pandemic Grief Scale (PGS), and Intolerance of Uncertainty Scale-12 (IUS-12). RESULTS Their OCS score was expected by the CRBS (β=0.30, p<0.001), FCV-19S (β=0.10, p<0.001), PGS (β=0.29, p<0.001), and IUS12 (β=0.04, p=0.024) (F=134.5, p<0.001). The COVID-related cognitive-behavioral model of hypochondriasis was feasible among firefighters who witnessed people's death. Their pandemic grief reaction and intolerance of uncertainty directly influenced their preoccupation with coronavirus, and viral anxiety and coronavirus reassurance-seeking behavior mediated the relationship. CONCLUSION Firefighters' viral anxiety and coronavirus reassurance-seeking behavior mediated the influence of pandemic grief reaction or intolerance of uncertainty on the preoccupation with coronavirus.
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Affiliation(s)
- Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Han-Sung Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soomin Jang
- Department of Psychiatry, SMG-SNU (Seoul National University) Boramae Medical Center, Seoul, Republic of Korea
| | - Yong-Wook Shin
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jeong-Hyun Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Public Health Medical Services, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Institute of Human Behavioral Medicine, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Jin Yong Jun
- Department of Psychiatry, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
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Hong Y, An H, Cho E, Ahmed O, Ahn MH, Yoo S, Chung S. Psychometric properties of the Korean version of questionnaires on adherence to physical distancing and health beliefs about COVID-19 in the general population. Front Psychiatry 2023; 14:1132169. [PMID: 37484663 PMCID: PMC10356985 DOI: 10.3389/fpsyt.2023.1132169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 05/04/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction We aimed to examine the psychometric properties of the Korean version of the questionnaires on adherence to physical distancing and health beliefs about COVID-19 in the general population in South Korea. In addition, we investigated how the various sections interacted with each other and with viral anxiety and depression, and ultimately affected adherence to physical distancing. Methods An anonymous online survey was conducted among members of the general population in South Korea between 10 and 18 January 2022. We recruited 400 respondents and measured their demographic information, symptoms, and responses to questions about COVID-19. First, we examined the reliability and validity of the questionnaires, which included questions about people's adherence to physical distancing guidelines and COVID-19-related health beliefs. Second, we examined the relationship between physical distancing and viral anxiety or depression, as assessed using the six-item Stress and Anxiety to Viral Epidemics (SAVE-6) scale and the Patient Health Questionnaire-9 (PHQ-9). Results All 400 participants (204 men, age 41.6 ± 10.8) completed the survey. Confirmatory factor analysis revealed a good model fit for adherence to physical distancing (CFI = 1.000, TLI = 1.019, RMSEA = 0.000, and SRMR = 0.034) and health beliefs about COVID-19 (CFI = 0.993, TLI = 0.991, RMSEA = 0.030, and SRMR = 0.052). It also showed good reliability for Factor I (Cronbach's α = 0.826) and Factor II (α = 0.740). Four categories of the COVID-19 health beliefs questionnaire also showed good reliability for perceived susceptibility (α = 0.870), perceived severity (α = 0.901), perceived benefit (α = 0.935), and barriers to following physical distancing (α = 0.833). Structural equation models showed that the effects of health beliefs and viral anxiety and depression were mediated mostly by personal injunctive norms. Goodness-of-fit measures indicated a good fit. (Chi-square = 24.425, df = 7, p < 0.001; CFI = 0.966; RMSEA = 0.079). Conclusion The Korean version of the COVID-19 adherence to physical distancing and health beliefs questionnaires showed good reliability and validity in the Korean general population. In addition, the effects of health beliefs, along with viral anxiety and depression, were mainly mediated by personal injunctive norms.
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Affiliation(s)
- Youjin Hong
- Department of Psychiatry, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Hoyoung An
- Department of Psychiatry, Keyo Hospital, Uiwang, Gyeonggi, Republic of Korea
| | - Eulah Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia
| | - Myung Hee Ahn
- Division of Psychiatry, Health Screening and Promotion Center, Asan Medical Center, Seoul, Republic of Korea
| | - Soyoung Yoo
- Department of Convergence Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Cho IK, Ahmed O, Lee D, Cho E, Chung S, Günlü A. Intolerance of Uncertainty Mediates the Influence of Viral Anxiety on Social Distancing Phobia Among the General Korean Population During the Coronavirus Disease 2019 Pandemic. Psychiatry Investig 2022; 19:712-721. [PMID: 36202106 PMCID: PMC9536886 DOI: 10.30773/pi.2022.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 06/20/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE We aimed to examined the reliability and validity of Korean version of Social Distancing Phobia scale, and whether intolerance of uncertainty mediates the association of the general population's social distancing phobia with viral anxiety and depression. METHODS Through this anonymous online survey, we collected responses from 400 individuals in the general Korean population. Participants' demographic information and rating scales scores, including the Social Distancing Phobia scale, Stress and Anxiety to Viral Epidemics-6 items, Patient Health Questionnaire-9, and Intolerance of Uncertainty-12 items. RESULTS Confirmatory factor analysis showed a good model fit, and the Korean version of Social Distancing Phobia scale showed good internal consistency. Social distancing phobia was significantly correlated with age (r=0.213, p<0.001), viral anxiety (r=0.390, p<0.001), depression (r=0.244, p<0.001), and intolerance of uncertainty (r=0.323, p<0.001). A linear regression analysis showed that age (β=0.235, p<0.001), viral anxiety (β=0.281, p<0.001), depression (β=0.121, p=0.009), and intolerance of uncertainty (β=0.200, p<0.001; adjusted R2=0.246, F=33.6, p<0.001) predicted social distancing phobia. Mediation analysis revealed that viral anxiety directly influenced social distancing phobia (z=6.48, p<0.001), and intolerance of uncertainty partially mediated this association (z=2.92, p=0.003). CONCLUSION Social distancing phobia may cause psychological stress but may also increase adherence to physical distancing measures and prevent the spread of viruses.
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Affiliation(s)
- Inn-Kyu Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Oli Ahmed
- Department of Psychology, University of Chittagong, Chattogram, Bangladesh.,National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Dongin Lee
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Eulah Cho
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seockhoon Chung
- Department of Psychiatry, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Aykut Günlü
- Department of Child Care and Youth Services, Pamukkale University, Denizli, Turkey
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