Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Apr:136:296-305.
doi: 10.1016/j.jpsychires.2021.02.008. Epub 2021 Feb 13.

Behavioural responses and anxiety symptoms during the coronavirus disease 2019 (COVID-19) pandemic in Japan: A large scale cross-sectional study

Guoxi Cai  1 , Yulan Lin  2 , Yixiao Lu  3 , Fei He  4 , Kouichi Morita  5 , Taro Yamamoto  6 , Kiyoshi Aoyagi  3 , Toshitsugu Taguri  7 , Zhijian Hu  8 , Haridah Alias  9 , Mahmoud Danaee  9 , Li Ping Wong  10
Affiliations

Behavioural responses and anxiety symptoms during the coronavirus disease 2019 (COVID-19) pandemic in Japan: A large scale cross-sectional study

Guoxi Cai et al. J Psychiatr Res. 2021 Apr.

Abstract

Background: This study explored the behavioural responses and anxiety symptoms of the general adult population in Japan during the ongoing coronavirus disease 2019 (COVID-19) outbreak.

Methods: A web-based cross-sectional survey was conducted between 12th and May 13, 2020. Quota sampling was used to attain equal gender and age distributions representative of the Japanese population.

Results: A total of 4127 complete responses were analysed. Higher educational level (B = 0.045, p = 0.002) and household income (B = 0.04, p = 0.009) were associated with a higher increase in preventive measures when comparing before and after the state of emergency was declared. The highest reported social anxiety was a feeling of fear (65.6%), followed by embarrassment (43.8%), keeping infection a secret (41.3%), avoidance (41.3%), and stigma (25.5%). A total of 86.1% of the respondents reported moderate to severe anxiety. The partial least square-based structural equation modelling (PLS-SEM) revealed that being female has the greatest effect (B = 0.246, p < 0.0001) on higher current preventive measures, followed by social anxiety (B = 0.119; p = 0.001) and State-Trait Anxiety Inventory scores (B = 0.153; p < 0.001). Perceived susceptibility (B = 0.033, p = 0.020), knowing someone who have been diagnosed with COVID-19 (B = 0.097, p < 0.001), higher income (B = 0.079, p < 0.001) and educational level (B = 0.045; p = 0.004) all had a small but significant effect on influencing levels of preventive measures.

Conclusions: A moderate level of preventive practices found in this study indicates the need to encourage behavioural change to limit the spread of the coronavirus. The provision of mental health services is warranted as anxiety symptoms are prevalent.

Keywords: Anxiety; COVID-19; Japan; Preventive behaviour.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Data collection period of the study and the trend of confirmed cases of COVID-19 in Japan.
Fig. 2
Fig. 2
Proportion of ‘All the time’ responses for behaviour change before and after the emergency announcement (N = 4127).
Fig. 3
Fig. 3
The Partial Least Square-Structural Equation Modelling (PLS-SEM) model of demographic factors influence the increment in preventive measures against COVID-19.
Fig. 4
Fig. 4
Proportion of ‘Agree/Strongly agree’ for social anxiety (N = 4127).
Fig. 5
Fig. 5
Research Model Using PLS Path Modelling for Factors Influencing current preventive measures against COVID-19.
See this image and copyright information in PMC

References

    1. Abraham T. Risk and outbreak communication: lessons from alternative paradigms. 2004. https://www.who.int/bulletin/volumes/87/8/08-058149/en/ - PMC - PubMed
    1. Azlan A.A., Hamzah M.R., Sern T.J., Ayub S.H., Mohamad E. Public knowledge, attitudes and practices towards COVID-19: a cross-sectional study in Malaysia. PloS One. 2020;15 doi: 10.1371/journal.pone.0233668. - DOI - PMC - PubMed
    1. Bellato A. Psychological factors underlying adherence to COVID-19 regulations: a commentary on how to promote compliance through mass media and limit the risk of a second wave. Soc. Sci. Human. Open. 2020;2:100062. doi: 10.1016/j.ssaho.2020.100062. - DOI - PMC - PubMed
    1. Chan J.F., Yuan S., Kok K.H., To K.K., Chu H., Yang J., Xing F., Liu J., Yip C.C., Poon R.W., Tsoi H.W. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020;395:514–523. doi: 10.1016/S0140-6736(20)30154-9. - DOI - PMC - PubMed
    1. Chin W.W. The partial least squares approach to structural equation modeling. Modern Methods Business Res. 1998;295:295–336.

Publication types