Emotional and Behavioral Consequences of the COVID-19 Pandemic: The Role of Health Anxiety, Intolerance of Uncertainty, and Distress (In)Tolerance.

Karoline S Sauer,Michael Witthöft,Stefanie M Jungmann

doi:10.3390/ijerph17197241

Abstract

The COVID-19 pandemic represents a worldwide threat to mental health. To optimize the allocation of health care resources, research on specific vulnerability factors, such as health anxiety, intolerance of uncertainty, and distress (in)tolerance, and particularly their effect on the time course of SARS-CoV-2 related anxiety appears crucial for supporting high risk groups suffering from elevated mental distress during the pandemic. N = 887 participants (78.4% female; Mage = 38.15, SD = 17.04) completed an online survey in Germany (April to mid-May 2020), comprising measures of SARS-CoV-2 related anxiety, health anxiety, safety and preventive behavior, intolerance of uncertainty, and distress intolerance. Higher levels of health anxiety pre and during COVID-19 were associated with an initially intensified increase (b = 1.10, p < 0.001), but later on a more rapid dampening (b = −0.18, p < 0.001) of SARS-CoV-2 related anxiety. SARS-CoV-2 related preventive behavior was intensified by both pre (b = 0.06, p = 0.01) and during (b = 0.15, p < 0.001) COVID-19 health anxiety, while reassurance behavior only was associated with health anxiety during COVID-19 (b = 0.14, p < 0.001). Distress intolerance and intolerance of uncertainty did not moderate the relationship between health anxiety and SARS-CoV-2 related anxiety and behavior. The results suggest detrimental effects of health anxiety on the emotional and behavioral response to virus outbreaks.

Highlights

Several studies on the outbreak of the COVID-19 pandemic (SARS-CoV-2) showed the considerable psychological impact of the pandemic
Health anxiety significantly increased since the outbreak of the COVID-19 pandemic (t(886) = |18.64|, p < 0.001, d = 0.39), which was shown on both subscales
The present study indicates that pre-existing health anxiety and health worries, which emerge during epidemics/pandemics influence the affective and behavioral responses to virus outbreaks

Summary

Introduction

Several studies on the outbreak of the COVID-19 pandemic (SARS-CoV-2) showed the considerable psychological impact of the pandemic. They found that up to 28% of respondents in China suffer from symptoms of anxiety and up to 37% from depressive symptoms during the COVID-19 pandemic [1,2], which is consistent with findings from European countries (e.g., Italy [3], Spain [4]) and from previous epidemics/pandemics [5,6,7] (for an overview of the mental health impact of the COVID-19 pandemic see [8]). Public Health 2020, 17, 7241; doi:10.3390/ijerph17197241 www.mdpi.com/journal/ijerph

Results

Discussion

Conclusion