Abstract
This study aims to investigate mental health among Chinese people living in areas with differing levels of infection severity during the COVID-19 outbreak. It also assesses the association between reciprocal and authoritarian filial piety and mental health in times of crises. A sample of 1,201 Chinese participants was surveyed between April and June 2020. Wuhan city (where 23.4% of participants resided), Hubei province outside Wuhan (13.4% of participants), and elsewhere in China (63.1% of participants) were categorized into high, moderate, and low infection severity areas, respectively. The Depression, Anxiety, and Stress Scale’s severity cut-points were used to categorize participants. In the overall sample, 20.9, 34.2, and 29.0% of the participants showed elevated (mild to extremely severe) levels of stress, anxiety, and depression. Those in the highest infection severity group were significantly more likely to be categorized as having elevated levels of stress, anxiety, and depression. General linear modeling was performed on a composite mental distress variable (taking into account stress, anxiety, and depression scores). This model indicated that, even after adjusting for group differences in age, gender, education, and filial piety, the high infection severity group displayed more mental distress than the low infection severity groups. The model also found reciprocal filial piety to have a negative association with mental distress. Conversely, authoritarian filial piety was found to be unrelated to mental distress when controlling for the other variables in the model. No evidence was found for an interaction between either authoritarian or reciprocal filial piety and infection severity, which suggests that the negative association observed between reciprocal filial piety and mental distress was relatively consistent across the three infection severity groups. The findings suggest that future public health programs may integrate the promotion of filial piety as a strategy to help Chinese people maintain good mental health in the face of pandemic crises.
Highlights
BackgroundBy November 15, 2020, the novel coronavirus (COVID-19) pandemic affected 220 countries and territories around the world, with 53,766,728 confirmed cases and 1,308,975 confirmed deaths (World Health Organization (WHO), 2020)
Analysis of variance indicated that the low [M = 40.66; 95% CI (40.24, 41.08); SD = 5.95], moderate [M = 41.23; 95% CI (40.29, 42.17); SD = 6.06], and high [M = 41.00; 95% CI (40.31, 41.69); SD = 5.88] infection severity groups did not differ in terms of reciprocal filial piety, F(2, 1,198) = 0.802, p = 0.448, η2 < 0.01
Bonferroni corrected pairwise comparisons indicated that authoritarian filial piety was higher among the moderate infection severity group [M = 26.15; 95% CI (24.80, 27.50); SD = 8.69] compared with the low [M = 24.47; 95% CI (23.99, 24.95); SD = 6.77, p = 0.020] and high infection severity groups [M = 23.91; 95% CI (23.19, 24.78); SD = 7.07, p = 0.005]
Summary
By November 15, 2020, the novel coronavirus (COVID-19) pandemic affected 220 countries and territories around the world, with 53,766,728 confirmed cases and 1,308,975 confirmed deaths (World Health Organization (WHO), 2020). The people of Wuhan, Hubei province, China—where the COVID-19 outbreak was first noted, and which has had the highest number of confirmed cases and deaths in China—experienced collective bereavement and grief (Cao Y. et al, 2020) when their city was forced into complete lockdown for 76 days. The constantly changing health alerts and overwhelming media coverage of the spread of COVID-19 within the city escalated fear, anxiety, and even stigma among city residents, all of which may have profound impacts on mental health. As Wuhan was the most severely affected area in China, it is reasonable to expect that the mental health of Wuhan residents may have been more severely negatively impacted compared with those living in less severely affected cities
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