Gender and COVID-19 related fear and anxiety: A meta-analysis

Studies conducted during the pandemic revealed strong associations between gender and COVID-19 related fear and anxiety. Females perceive coronavirus as a greater threat to personal health and population than males. The aim of the current meta-analysis is to estimate gender difference in COVID-19 related fear and anxiety. The second purpose of this study is to clarify the role of potential moderators in COVID-19 fear and anxiety. For these reasons, studies published between March 2020 and October 2021 were searched in various databases (Web of Science, SCOPUS, PubMed, and Google Scholar). In total, 315 studies met the inclusion criteria, and 60 studies for COVID-19 related fear and 23 studies for COVID-19 related anxiety were included in the current study. Cohen's d effect size values were calculated based on these individual studies showing the difference between males and females in terms of COVID-19 related fear and anxiety. Results revealed that gender has a moderate and statistically significant effect on COVID-19 related fear (ES = 0.307) and anxiety (ES = 0.316) in favor of females. Moderator analyses showed that continent variable was a statistically significant moderator of gender difference in COVID-19 related fear and anxiety. The highest effect size of gender differences in COVID-related fear and anxiety were obtained from the studies conducted in Europe. However, other moderators (the average age of sample, culture, timing, and population) were not statistically significant. Although this meta-analysis has a few limitations, the findings showed that COVID-19 outbreak negatively affected females more.

The Effect of COVID-19 Anxiety on General Health: the Role of COVID-19 Coping

The Coronavirus Disease 2019 (COVID-19) epidemic has unprecedently affected many aspects of people’s lives including their health. This study examined the mediating effect of COVID-19 coping strategies on the relationship between COVID-19 anxiety and general health. Participants (70% females) included 4624 adults (M_age = 30.29 ± 10.97 years) collected through an online survey using a convenience sampling approach. Exploratory and confirmatory factor analyses yielded a one-factor structure for the COVID-19 Anxiety Scale (CFI = .98, TLI = .96, SRMR = .02, RMSEA = .09), COVID-19 Coping Scale (CFI = .97, TLI = .97, SRMR = .03, RMSEA = .12), and General Health Scale (CFI = .99, TLI = .97, SRMR = .01, RMSEA = .04) which were developed for the purpose of this study and exhibited satisfactory reliability. Findings showed that COVID-19 anxiety was negatively related with COVID-19 coping and general health. COVID-19 coping had a positive relationship with general health. Hierarchical multiple regression analyses revealed that COVID-19 coping partially mediated the relationship between COVID-19 anxiety and general health. These findings shed more light on the mechanism underlying between COVID-19 anxiety and health. The findings are important for tailoring and implementing coping-based intervention strategies to reduce the impact of COVID-19 anxiety on general health.

Demographic, gadget and internet profiles as determinants of disease and consequence related COVID-19 anxiety among Filipino college students

In the context of the nationwide shift to online learning due to the COVID-19 pandemic and its possible effect on mental health, this study investigated the relationship between demographic, gadget and Internet profiles, and disease and consequence related COVID-19 anxiety among Filipino college students. This is a quantitative cross-sectional study. A total of 952 students participated in the online survey. Descriptive and inferential statistics were used to draw insights from the data. Findings suggest that majority of the student respondents had high levels of disease and consequence related COVID-19 anxiety. Students from poorer households, who do not own laptops and desktop computers, and those with limited Internet connection exhibited higher levels of disease-related COVID-19 anxiety. Younger, poorer, female students who were enrolled in lower year levels, do not own laptops or tablets, and have limited or borrowed Internet connectivity demonstrated higher levels of consequence-related COVID-19 anxiety.

Using Fear and Anxiety Related to COVID-19 to Predict Cyberchondria: Cross-sectional Survey Study

BACKGROUND

Studies have highlighted that fear and anxiety generated by COVID-19 are important psychological factors that affect all populations. There currently remains a lack of research on specific amplification factors regarding fear and anxiety in the context of the COVID-19 pandemic. Despite established associations between anxiety sensitivity, intolerance of uncertainty, and cyberchondria, empirical data investigating the associations between these three variables, particularly in the context of the COVID-19 pandemic, are currently lacking. Urgent research is needed to better understand the role of repeated media consumption concerning COVID-19 in amplifying fear and anxiety related to COVID-19.

OBJECTIVE

This study investigated the associations between fear of COVID-19, COVID-19 anxiety, and cyberchondria.

METHODS

Convenience sampling was used to recruit respondents to participate in an online survey. The survey, which was distributed via social media and academic forums, comprised the Cyberchondria Severity Scale, Fear of COVID-19 Scale, Coronavirus Anxiety Scale, Anxiety Sensitivity Index, and Intolerance of Uncertainty Scale. Multiple mediation analyses were conducted using structural equation modeling.

RESULTS

A total of 694 respondents (males: n=343, females: n=351) completed the online survey. The results showed that fear and anxiety generated by COVID-19 predicted cyberchondria (fear: β=.39, SE 0.04, P<.001, t=11.16, 95% CI 0.31-0.45; anxiety: β=.25, SE 0.03, P<.001, t=7.67, 95% CI 0.19-0.32). In addition, intolerance of uncertainty and anxiety sensitivity mediated the relationship between fear and anxiety generated by COVID-19 with cyberchondria. In a reciprocal model, the standardized total effects of cyberchondria on fear of COVID-19 (β=.45, SE 0.04, P<.001, t=15.31, 95% CI 0.39-0.51) and COVID-19 anxiety (β=.36, SE 0.03, P<.001, t=11.29, 95% CI 0.30-0.41) were statistically significant, with moderate effect sizes. Compared to males, females obtained significantly higher scores for cyberchondria (t_1,692=-2.85, P=.004, Cohen d=0.22), COVID-19 anxiety (t_1,692=-3.32, P<.001, Cohen d=0.26), and anxiety sensitivity (t_1,692=-3.69, P<.001, Cohen d=0.29).

CONCLUSIONS

The findings provide a better understanding of the role of COVID-19 in amplifying cyberchondria. Based on these results, cyberchondria must be viewed as a significant public health issue. Importantly, increasing awareness about cyberchondria and online behavior at both the individual and collective levels must be prioritized to enhance preparedness and to reduce the adverse effects of current and future medical crises.

The COVID-19 anxiety syndrome and selective attentional bias towards COVID-19-related stimuli in UK residents during the 2020-2021 pandemic

The psychological and social effects of the COVID‐19 pandemic are pervasive, and there is potential for a long‐lasting impact on mental health. In the current study, we sought to provide, in a representative sample of UK residents during the third COVID‐19 lockdown in February 2021, further evidence for the validation of the COVID‐19 anxiety syndrome construct. We did this by evaluating the COVID‐19 anxiety syndrome against measures of personality, health anxiety and COVID‐19 anxiety in predicting levels of generalized anxiety and depression and by examining whether increased health anxiety and COVID‐19 psychological distress (COVID‐19 anxiety and COVID‐19 anxiety syndrome) scores were associated with increased attentional bias to COVID‐19‐related stimuli. A series of correlation analyses revealed that neuroticism, health anxiety, COVID‐19 anxiety and COVID‐19 anxiety syndrome scores were positively and significantly correlated with generalized anxiety and depression scores and that the perseveration component of the COVID‐19 anxiety syndrome predicted generalized anxiety and depression scores independently of age, gender, conscientiousness, openness, health anxiety and COVID‐19 anxiety. Furthermore, results indicated that only the total COVID‐19 anxiety syndrome score and the scores on the avoidance and perseveration components were positively and significantly correlated with attentional bias indices. More specifically, the general attentional bias index was only shown to be positively and significantly correlated with the total COVID‐19 anxiety syndrome score and its perseveration component, while slowed disengagement was only shown to be negatively and significantly correlated with the total COVID‐19 anxiety syndrome score and its avoidance component. The implications of these findings are discussed.

Well-Being Reduces COVID-19 Anxiety: A Three-Wave Longitudinal Study in China

The coronavirus disease 2019 (COVID-19) pandemic threatens human beings' livelihoods and mental health, which lowers their well-being and gives rise to anxiety. This study examines whether there is a causal relationship (and, if so, in which direction) between people's well-being and COVID-19 anxiety. Two hundred and twenty-two participants (54.50% female, M _age = 31.53, SD = 8.17) from 26 provinces of China completed measures of subjective well-being (SWB) and COVID-19 anxiety at three key nodes of the development of COVID-19 in China. The results showed that people's SWB and COVID-19 anxiety fluctuated with the peak (T1), decline (T2), and trough stages (T3) of the COVID-19 pandemic. Meanwhile, the cross-lagged analysis showed that the participants' SWB at T0 (pre-pandemic stage; the base level of SWB) and T1 could significantly predict their COVID-19 anxiety at T1 and T2 respectively. However, SWB at T2 was not associated with the COVID-19 anxiety at T3. Furthermore, COVID-19 anxiety could not predict subsequent SWB from T1 to T3. The current findings contribute to clarifying the causal relationship between well-being and anxiety through the development of epidemics, as well as finding ways to alleviate people's COVID-19 anxiety.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10902-021-00385-2.

Gambling and gaming during COVID-19: The role of mental health and social motives in gambling and gaming problems

BACKGROUND

The uncertain and stressful global situation caused by the COVID-19 pandemic has the potential to cause anxiety and impact people's mental health. Simultaneously, social distancing policies have isolated people from their normal social interactions. These societal changes have inevitably influenced gambling and gaming practices, and many people may have turned to betting or gaming as a means of social exchange. This study examined the influence of COVID-19 anxiety on increased mental health problems and their relationship to gambling and gaming problems. The mediating role of social motives for gambling and gaming was also investigated.

MATERIAL AND METHODS

Finnish adults (N = 1530; Mage = 46.67; 50.33% male) were recruited from a volunteer participant panel to participate in a survey study. COVID-19 anxiety was assessed using a scale adapted from the Spielberger State-Trait Anxiety Inventory. Mental health problems were evaluated with the five-item Mental Health Inventory. Gambling problems were measured using the Problem Gambling Severity Index, and gaming problems were measured with the Internet Gaming Disorder Test. Social motives for gaming were evaluated using a single-item measure. Analyses used generalised structural equation modelling.

RESULTS

COVID-19 anxiety predicted increased mental health problems, which were associated with heightened gambling and gaming problems. Social motives for gambling and gaming were a significant mediator, suggesting that gambling and gaming problems are emphasized markedly among those who are socially motivated by and involved in such games.

CONCLUSIONS

Mental health problems experienced during the pandemic and the social properties of games might accentuate gambling and gaming problems.

Fear of COVID-19 changes the motivation for physical activity participation: Polish-Chinese comparisons

BACKGROUND

COVID-19 has brought people many negative emotions, such as fear and anxiety about the epidemic. However, when people in different countries face the COVID-19 epidemic, the impact is also different due to different cultural and sports habits. Therefore, this study compares China and Poland's sports motivations in the face of COVID-19 anxiety to find out the cultural differences behind them.

PARTICIPANTS AND PROCEDURE

In the study were N = 674 participants (female n = 407, male n = 260, other n = 4). Their average age was M = 29.86, SD = 11.03. There were n = 381 participants in the Chinese sample, and n = 293 in Polish. The scales used for the purpose of the study were the Inventory of Physical Activity Objectives (IPAO) and the Coronavirus Anxiety Scale (CAS).

RESULTS

The study results showed that the increased level of COVID-19 anxiety changed selected motives for physical activity, and different changes of motives characterized women and men as well as people of different ages. As predicted in the study model, culture was the moderator of the shifts of the selected motives.

CONCLUSIONS

The understanding of what motivates individuals to participate in sport seems to have significant value, especially for health practitioners and researchers to design appropriate interventions and programs to increase activity.

Competitive anxiety or Coronavirus anxiety? The psychophysiological responses of professional football players after returning to competition during the COVID-19 pandemic

OBJECTIVE

This study aimed to examine the relationship between competitive anxiety, fear/anxiety of COVID-19, and autonomic and endocrine stress responses in professional football players after returning to competition during the COVID-19 pandemic.

METHODS

Ninety male professional football players (age: 26.33 ± 2.48 yr) volunteered to participate in this study, which included an official competition. Psychophysiological responses, including the Fear of COVID-19 Scale, the Coronavirus Anxiety Scale, and the Competitive State Anxiety Inventory-2 Revised, were collected 30 min before the competition. In addition, salivary alpha-amylase (sAA) and salivary cortisol (sCort) were collected at 8 a.m. and 15 min before the competition.

RESULTS

The main findings, based on the Pearson correlation, showed significant positive correlations between COVID-19 anxiety and somatic competitive anxiety (p = 0.01), cognitive competitive anxiety (p = 0.01), and competition response of sCort and sAA (p = 0.01). Moreover, fear of COVID-19 was positively correlated with COVID-19 anxiety (p = 0.01). On the contrary, the awakening response of sCort and sAA was not found to be correlated with psychological parameters (all p > 0.05). The analysis also indicated that there was no significant correlation between self-confidence with other psychological and physiological variables (all p > 0.05). The regression analysis showed that cognitive anxiety was a relevant predictor for the competition response of sCort and sAA (p < 0.05). Moreover, COVID-19 anxiety was the only predictor of somatic and cognitive anxiety (p < 0.05).

CONCLUSIONS

The present study provides the first preliminary evidence that COVID-19 anxiety and competitive anxiety might pose a negative impact on the athletic performance of professional football players during COVID-19 pandemic competitions. Thus, research is needed to build a strategy to reduce the psychophysiological stress related to COVID-19 and competition response.

The Italian COVID-19 Anxiety Syndrome Scale: Investigation of the COVID-19 anxiety syndrome and its association with psychological symptoms in an Italian population

INTRODUCTION

The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a quick and reliable scale assessing dysfunctional coping strategies activated in response to COVID-19 fear and threat. The present study aimed to provide a preliminary validation of the Italian version of the C-19ASS and investigated whether the C-19ASS would mediate the relationship between the Big Five personality traits and psychological outcomes.

METHOD

In Study 1, a community sample of 271 participants completed the Italian version of the C-19ASS and results were subjected to a Principal Component Analysis. In study 2, a community sample of 484 participants completed the Italian version of the C-19ASS and a series of measures assessing COVID-19 anxiety, COVID-19 fear, functional impairment, personality traits, depression, generalized anxiety and health anxiety. Internal consistency, concurrent and incremental validity were assessed. Path analyses were run.

RESULTS

Factor analysis identified a two-factor solution (i.e., C-19ASS Perseveration and C-19ASS Avoidance) and confirmatory factor analysis suggested a two-factor model best fits the data. The Italian version of the C-19ASS showed good internal consistency. There was also evidence of convergent validity and incremental validity. Path analyses showed that C-19ASS Perseveration mediates the relationship between emotional stability and psychological symptoms (depression, generalized anxiety and health anxiety).

CONCLUSION

The Italian version of the C-19ASS appears to be a reliable and valid measure of the COVID-19 anxiety syndrome. The COVID-19 anxiety syndrome could be a suitable therapeutic target to reduce psychological symptoms typically linked to pandemic events, such as depression generalized anxiety and health anxiety.

Investigating COVID-19 stress and coping: Substance use and behavioural disengagement

The purpose of this online empirical study was to examine the relationship between COVID‐19 stress, coping including substance use and behavioural disengagement, and avoidance behaviour early on in the COVID‐19 pandemic. Participants, recruited from Amazon's Mechanical Turk (MTurk, N = 730), were adults from Canada, the United States, Italy, Germany and the United Kingdom. Results of path analysis showed that feeling threatened by the virus, predicted greater COVID‐19 anxiety, which was related to greater substance use to cope with the virus, as well as more behavioural disengagement, which predicted less avoidance behaviour. Implications of the results are discussed, particularly the relationship between coping and avoidance behaviour during the pandemic.

The Arab COVID-19 Anxiety Syndrome Scale (C-19ASS): COVID-19 anxiety syndrome and psychological symptoms in the Saudi Arabian population

INTRODUCTION

The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a reliable scale assessing dysfunctional coping strategies activated in response to COVID-19 fear and threat. The present study aimed to provide a validation of the Arabic version of the C-19ASS and to explore the association between the C-19ASS and psychological symptoms syndrome.

METHOD

In Study 1, a community sample of 404 participants completed the Arabic version of the C-19ASS and results were subjected to an exploratory factor analysis. In Study 2, a community sample of 903 participants completed the Arabic version of the C-19ASS and a series of measures assessing depressed mood and anhedonia, generalized anxiety and health anxiety. Internal consistency, construct validity and incremental validity were assessed. Associations between C-19ASS and psychological symptoms were assessed.

RESULTS

Factor analysis identified a two-factor solution (i.e., C-19ASS-Perseveration and C-19ASS-Avoidance), and confirmatory factor analysis suggested a two-factor model best fits the data. The Arabic version of the C-19ASS showed good internal consistency, good construct and incremental validity. COVID-19 anxiety syndrome was associated with more severe anxiety symptoms, depressive symptoms and health anxiety. Females had higher levels of COVID-19 anxiety syndrome than males. Participants diagnosed with COVID-19, and those who had experienced loss as a consequence of COVID-19, had higher levels of COVID-19 anxiety syndrome (Perseveration).

CONCLUSIONS

The Arabic version of the C-19ASS appears to be a reliable and valid measure of the COVID-19 anxiety syndrome. The COVID-19 anxiety syndrome could be a suitable therapeutic target to improve psychological recovery during the COVID-19 pandemic among Arabs.

Prevalence of anxiety symptoms among Chinese university students amid the COVID-19 pandemic: A systematic review and meta-analysis

College students in China are particularly vulnerable to worry. In the meanwhile, the COVID-19 pandemic might worsen anxiety symptoms. However, due to the inconsistency of many studies regarding anxiety symptoms, it has proven challenging to provide accurate psychiatric health treatments to undergraduates. Therefore, in order to determine the prevalence of anxiety among Chinese university students during the COVID-19 epidemic, this study will undertake a systematic review and meta-analysis.

English databases (i.e Embase (Ovid), APA PsycInfo, Medline, Pubmed, Cochrane Library) were utilized to identify papers that provide information on the incidence of anxiety among Chinese college students during the pandemic. Two authors evaluated the qualifications of relevant studies, assessed the risk of bias (RoB), and retrieved data. RoB was evaluated using the cross-sectional study quality evaluation criteria from the American Agency for HealthCare Quality and Research (AHRQ). Three hundred seventy-three records were retrieved. Twenty-five studies were eventually included, involving 1,003,743 Chinese college students. The findings of the study identified that the pooled prevalence of anxiety symptoms was 25.0% (95% CI: 21%–29%, P < 0.001), and those among medical-related professionals were lower than those of the general population (22.1% vs. 25%, P < 0.001). In addition, the prevalence of studies with more female respondents was higher than those with fewer female respondents (26.4% vs. 8%). In the later phases of the COVID-19 pandemic compared to the early stages, anxiety prevalence is higher (29.1% vs. 17.2%). Finally, using meta-regression to explore the source of heterogeneity, this study found that the most potential source was whether the graduate students or otherwise.

This meta-analysis revealed that during the COVID-19 pandemic, a quarter of Chinese college students had anxiety symptoms. Therefore, it is necessary to provide continuous psychological assessment and treatment services for college students.

Exploring variables related to medical surrogate decision-making accuracy during the COVID-19 pandemic

OBJECTIVE

Surrogate medical decision making is common in the United States healthcare system. Variables that may influence surrogate decision making have been proposed. Little work has examined relations between these variables and outcomes of surrogate decision making. This study investigated whether surrogates' characteristics, including their knowledge of treatment options, and interpersonal factors predicted surrogates' accuracy and intervention selections. Specifically, predictor variables included: trust in the medical profession, trait-level anxiety, depression, anxiety about COVID-19, religiosity, perceived emotional support, understanding of treatment options, empathy, willingness to accept responsibility for medical decisions, reluctance to burden others, and perceived similarity between oneself and the patient.

METHODS

154 pairs of patients and their surrogates completed an online survey. Patients indicated preferred treatments in hypothetical decision scenarios. Surrogates indicated the treatment that they thought the patient would prefer.

RESULTS

When taken all together in a predictive model, the variables significantly predicted surrogates' accuracy, F (6) = 3.03, R² = .12, p = .008. Variables also predicted selection of intensive interventions, F (4) = 5.95, R² = .14, p = .00. Surrogates reporting greater anxiety about COVID-19 selected more intensive interventions.

CONCLUSIONS

Consistent with prior research, this study found that surrogates' characteristics influence the interventions they choose, with anxiety about COVID-19 having considerable bearing on their chosen interventions.

PRACTICE IMPLICATIONS

These findings can inform development of decision-making interventions to improve surrogates' accuracy. Providers may attend to variables highlighted by this study to support surrogates, particularly within the stressful context of COVID-19 and possible future pandemics.

Depression, COVID-19 Anxiety, Subjective Well-being, and Academic Performance in University Students With COVID-19-Infected Relatives: A Network Analysis

This study aimed to examine the relationship between anxiety, depression, subjective well-being, and academic performance in Peruvian university health science students with COVID-19-infected relatives. Eight hundred two university students aged 17-54 years (Mean 21.83; SD = 5.31); 658 females (82%) and 144 males (18%); who completed the Patient Health Questionnaire-2, Coronavirus Anxiety Scale, Subjective Well-being Scale (SWB), and Self-reporting of Academic Performance participated. A partial unregularized network was estimated using the ggmModSelect function. Expected influence (EI) values were calculated to identify the central nodes and a two-tailed permutation test for the difference between the two groups (COVID-19 infected and uninfected). The results reveal that a depression and well-being node (PHQ1-SWB3) presents the highest relationship. The most central nodes belonged to COVID-19 anxiety, and there are no global differences between the comparison networks; but at the local level, there are connections in the network of COVID-19-infected students that are not in the group that did not present this diagnosis. It is concluded that anxious-depressive symptomatology and its relationship with well-being and evaluation of academic performance should be considered in order to understand the impact that COVID-19 had on health sciences students.

Early maladaptive schemas and COVID-19 anxiety: The mediational role of mistrustfulness and vulnerability to harm and illness

BACKGROUND

Early maladaptive schemas (EMS), as lifelong psychological structures, tend to be associated with psychopathological symptomatology. Previous research has suggested that schemas act as psychological vulnerabilities to stressful life situations, such as the present worldwide COVID-19 pandemic. In this context, anxiety and psychological distress have been documented as two of the main psychological symptoms associated with the COVID-19 pandemic. However, the associations between specific EMS and COVID-19 anxiety remain unexplored. Therefore, this study aims to explore the relationships between EMS, COVID-19 anxiety as well as other mental health variables such as psychological well-being, distress and life satisfaction.

METHODS

In a cross-sectional design, 249 individuals (M = 34.2, SD = 12.0) completed several self-report measures.

RESULTS

EMS from different schematic domains were positively associated with COVID-19 anxiety and psychological distress and negatively associated with psychological well-being and life satisfaction. An EMS hierarchical regression model predicted COVID-19 anxiety. Mistrustfulness and vulnerability to harm and illness mediated the relationships between COVID-19 anxiety, psychological distress and life satisfaction.

CONCLUSIONS

According to these results, mistrustfulness and vulnerability to harm and illness can act as underlying variables for the decrease in mental health associated with the COVID-19 pandemic.

Investigating the Association Between Obsessive-Compulsive Disorder Symptom Subtypes and Health Anxiety as Impacted by the COVID-19 Pandemic: A Cross-Sectional Study

Background

Since the COVID-19 outbreak was declared a global pandemic, public health messages have emphasised the importance of frequent handwashing in limiting the transmission of the virus. Whilst crucial in controlling transmission, such messaging may have an adverse effect on individuals with OCD.

Methods

A cross-sectional study was conducted, with a total of 332 participants recruited. Participants who scored above the optimal cut-off score on the Obsessive-Compulsive Inventory Revised edition (OCI-R) were included in the analysis (n = 254). Scores on the six subscales of the OCI-R were correlated with responses to a COVID-19 Impact measure.

Results

Factor analysis of the COVID-19 Impact measure revealed that items loaded on two components of the measure (handwashing and distress-avoidance). Canonical correlation analyses revealed significant associations between the OCI-R subscales and COVID-19 Impact measure, F (12, 490) = 8.14, p = 0.001, and the SHAI subscales with the COVID-19 Impact Measure, F (4, 498) = 8.18, p = 0.001). Specifically, washing and checking OCI-R subscales correlated with both components of the COVID-19 Impact measure, as did the health anxiety and beliefs SHAI subscales. Content analysis revealed disruption to treatment delivery and worsening symptom severity in participants with contamination-related OCD.

Discussion

Contamination and checking OCD subtypes have been associated with increased hand-washing behaviour and avoidance of distress-inducing cues. Consideration should be given to targeted support tailored to patients with these subtypes of OCD.

Perceived risk of COVID-19 exposure and poor COVID-19 prognosis impair sleep: The mediating and moderating roles of COVID-19-related anxiety and knowledge

The ongoing COVID‐19 pandemic has been linked to increased levels of stress, depression, and anxiety in many people around the world. Therefore, identifying individuals at risk of psychosocial burden during this unprecedented crisis is essential for developing prevention measures and treatment options for mental health issues. To this aim, we investigated two risk groups: individuals at higher risk of exposure to the virus and individuals at higher risk of poor prognosis if they contract the virus. We conducted a survey (N = 4167) with a representative sample of the German population and assessed perceived risk of COVID‐19 exposure and poor prognosis if infected, COVID‐19‐related anxiety, problems with sleep and daytime functioning, as well as self‐reported knowledge about the disease. Results showed that perceived risk group membership was linked to increased problems with sleep and daytime functioning via elevated levels of COVID‐19‐related anxiety. This mediated effect was further moderated by self‐reported COVID‐19 knowledge, but only for individuals who rated themselves at higher risk of COVID‐19 exposure. Thus, knowledge buffered the negative effect of exposure risk on anxiety and ultimately on sleep in this risk group. Reaching individuals at increased risk of exposure with clear information about the disease, how to prevent infection, and treatment options could be an effective strategy to contain anxiety levels and promote good sleep, which is important for general well‐being.

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.

The effects of gratitude and kindness on life satisfaction, positive emotions, negative emotions, and COVID-19 anxiety: An online pilot experimental study

The continuous surge in the number of confirmed diagnoses and fatalities associated with the coronavirus disease 2019 (COVID-19) has caused debilitating economic, educational, social, and psychological issues. However, little is known about how psychological interventions may boost well-being outcomes amid the pandemic. This research addresses this gap by examining the effects of gratitude and kindness interventions on life satisfaction, positive emotions, negative emotions, and COVID-19 anxiety via an online pilot experimental study. A 3-week online pilot experiment was implemented among 107 Filipino undergraduate students (M = 20.27; SD = 1.10). These participants were randomly assigned to kindness (n = 37), gratitude (n = 32), and control (n = 38) conditions. The results showed that there were significant differences on positive emotions when controlling for the baseline well-being, gratitude, and kindness scores across all conditions (i.e., gratitude, kindness, and control). Participants assigned in the gratitude and kindness conditions had significantly higher scores on positive emotions than those in the control condition. The findings point to the emotional benefits associated with promoting gratitude and kindness during the COVID-19 pandemic. This research contributes to scarce literature on the applicability of well-being interventions in non-Western cultural contexts.

Health anxiety, perceived risk and perceived control in following recommended preventive measures during early COVID-19 response in Romania

BACKGROUND

Compliance with government-recommended preventive measures represents a key factor in mitigating the negative consequences of coronavirus disease 2019 (COVID-19).

AIMS

The study investigated the relation between health anxiety, perceived risk and perceived control as predictors of coronavirus disease 2019 (COVID-19)-related anxiety and preventive behaviours (both adaptive and dysfunctional/excessive) during the early pandemic response in Romania.

METHOD

Data were collected in April-May 2020, and the sample comprised 236 participants, 192 women, mean age 31.44 (s.d. = 10.30, age range 16-67).

RESULTS

Our results showed that health anxiety and perceived control, but not perceived risk predicted adaptive preventive behaviours, whereas dysfunctional behaviours were predicted by health anxiety alone. COVID-19-related anxiety was predicted by health anxiety and perceived risk, with perceived control emerging as a non-significant predictor. Also, we found that the effect of health anxiety on COVID-19-related anxiety was mediated by perceived risk, and that perceived control acted as a moderator in the relation between health anxiety and dysfunctional (but not adaptive) preventive behaviours.

CONCLUSIONS

Our results suggest health anxiety is a significant predictor of COVID-19-related anxiety and preventive behaviours. Also, adaptive, but not dysfunctional, preventive behaviours were additionally predicted by perceived control, pointing to the important role of control and self-efficacy in explaining adherence to recommendations.

The COVID-19 fear, anxiety, and resilience among emergency nurses

Background

Besides physical complications, COVID-19 is associated with psychological issues such as fear and anxiety. High resilience in nurses enables them to adopt positive coping mechanisms and successfully operate in the stressful environment of COVID-19 wards. The present study aimed to evaluate the correlation between COVID-19 fear and anxiety with resilience in the emergency nurses of the hospital affiliated with Kurdistan University of Medical Sciences (west of Iran) in 2021.

Materials and methods

This cross-sectional study was conducted on 295 emergency nurses of selected hospitals in Kurdistan province, Iran, in 2021. Data were collected using a demographic questionnaire, Fear of COVID-19 Scale (FCV-19S), Corona Disease Anxiety Scale (CDAS), and Connor-Davidson Resilience Scale (CD-RISC). Data analysis was performed in R software version 3.6.3.

Results

The mean scores of resilience, COVID-19 fear, and COVID-19 anxiety were 55.07 ± 19.82 (ranging from 0 to 100), 20 ± 7.37 (ranging from 7 to 35) and 36.48 ± 13.21 (ranging from 18 to 54) respectively. There was a negative and significant correlation between resilience with COVID-19 fear (r = -0.449, p = 0.001), COVID-19 anxiety (r = 0.458, p = 0.001). A significant correlation was observed between COVID-19 fear and anxiety, which indicated that if the other demographic variables remained unchanged, a one-unit increase in COVID-19 fear and anxiety decreased the mean resilience score by -0.66 (P = 0.008) and -0.34 (P = 0.015), respectively.

Conclusion

COVID-19 fear and anxiety were significantly correlated. Therefore, providing training courses for promoting resilience could reduce the fear and anxiety of nurses during the COVID-19 pandemic.

Short report: COVID-19-related anxiety is associated with mental health problems among adults with rare disorders

BACKGROUND

For adults with rare disorders, COVID-19 can be more severe and deadlier. This may lead to anxiety about COVID-19 among adults with rare disorders, including worries about being infected. COVID-19 anxiety is linked with mental health problems in the general population.

AIMS

To examine the levels of mental health problems and COVID-19 anxiety, and their association, among adults with rare disorders.

METHODS AND PROCEDURES

Adults with rare disorders (N = 58, M_age = 45.2 years, SD = 12.7, 69.0 % females, 31.0 % males) answered standardized mental health and COVID-19 anxiety questionnaires online. Their scores were compared with samples without rare disorders.

OUTCOMES AND RESULTS

Mental health problems were higher than in a sample without rare disorders (effect size d = 1.14), as was COVID-19 anxiety (effect size d = 0.53). COVID-19 anxiety correlated significantly with mental health problems (r = 0.46). Controlling for age, gender, and work status, COVID-19 anxiety explained 16.1 % of the variance in mental health problems (ΔR² = 0.161, p = 0.001).

CONCLUSIONS AND IMPLICATIONS

COVID-19 anxiety is higher than norms and associated with mental health problems for adults with rare disorders. During the pandemic, clinicians are recommended to assess COVID-19 anxiety for patients with rare disorders.

Relationship between COVID-19 anxiety and fear of death: the mediating role of intolerance of uncertainty among a Turkish sample

The Coronavirus Disease 2019 (COVID-19) pandemic has increased the salience of death in our lives. The aim of this study is to uncover potential mechanisms underlying fear of death during the pandemic. A sample of 478 volunteers (312 females and 166 males) aged 18 years and older participated voluntarily in this study. Coronavirus Anxiety Scale, Multidimensional Mortality Awareness Measure, Intolerance of Uncertainty Scale, and Personal Information Form were used for data collection. The mediating role of intolerance of uncertainty in the relationship between COVID-19 anxiety and fear of death was determined using the bootstrapping method. COVID-19 anxiety was associated with increased intolerance of uncertainty, and fear of death. Intolerance of uncertainty was associated with increased fear of death. Furthermore, intolerance of uncertainty partially mediated the relationship between COVID-19 anxiety and fear of death. Results suggest that intolerance of uncertainty is a critical variable in the relationship between COVID-19 anxiety and fear of death. The current research adds to our knowledge of fear of death by investigating COVID-19 anxiety and intolerance of uncertainty. Additionally, this study underlies and contributes to the consideration of psychological health of individuals during the pandemic process. The results are discussed within the context of the COVID-19 pandemic.

Relationships Between Resilience, Mental Well-Being, and COVID-19 Worries in Collegiate Student-Athletes

The onset of the COVID-19 pandemic was associated with robust declines in well-being for collegiate student-athletes. Worries about COVID-19 have frequently been associated with worsening well-being; therefore, it is important to examine protective factors against well-being decrements. Resilience, one's ability to respond to stress and adversity, may be one such factor. Despite this possible influence, resilience has not yet been studied in student-athletes in this context as the pandemic has progressed. Therefore, the purpose of this study was to examine the moderating role of resilience on the relationship between COVID-19 worries and well-being. In this cross-sectional design, National Collegiate Athletic Association Division III athletes (N = 91) at one university completed surveys on COVID-19 worries, resilience, and well-being between February and March 2021. All competitions had been postponed until the Spring 2021 semester. The findings revealed a negative correlation between COVID-19 worries and well-being (r = -0.21, p = 0.05) and a positive correlation between resilience and well-being (r = 0.44, p < 0.001). Additionally, multiple regression and simple slopes analyses showed that individuals with higher resilience endorsed greater scores of well-being, even when COVID-19 worries increased (β = 0.38, p = 0.02). In conclusion, our results suggest that resilience had a moderating effect on the relationship between COVID-19 worries and well-being.