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. 2020 Oct 3;17(19):7241.
doi: 10.3390/ijerph17197241.

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

Karoline S Sauer  1 , Stefanie M Jungmann  1 , Michael Witthöft  1
Affiliations

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

Karoline S Sauer et al. Int J Environ Res Public Health. .

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.

Keywords: Covid-19; distress tolerance; health anxiety; intolerance of uncertainty; safety behaviors; virus anxiety.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Course of anxiety in relation to SARS-CoV-2 (including COVID-19) on individual level during the COVID-19 pandemic (December 2019, January 2020 and March 2020 retrospectively assessed) (fitted trajectory of sample development added).
Figure 2
Figure 2
Anxiety in relation to SARS-CoV-2 (including COVID-19) (left) and in relation to other severe diseases (not COVID-19; e.g., cancer) (right) as a function of health anxiety (SHAI) pre COVID-19 over the course of the COVID-19 pandemic (December [Dec] 2019, January [Jan] 2020, and March [Mar] 2020, retrospectively assessed).
See this image and copyright information in PMC

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