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. 2021;14(3):515-536.
doi: 10.1007/s41811-021-00113-x. Epub 2021 Jun 21.

Anxiety Sensitivity Mediates Relations Between Mental Distress Symptoms and Medical Care Utilization During COVID-19 Pandemic

Juliana M B Khoury  1 , Margo C Watt  1   2 , Kim MacLean  1
Affiliations

Anxiety Sensitivity Mediates Relations Between Mental Distress Symptoms and Medical Care Utilization During COVID-19 Pandemic

Juliana M B Khoury et al. Int J Cogn Ther. 2021.

Abstract

Anxiety and uncertainty are common during pandemics. The present study extended previous pandemic research by investigating the role of two transdiagnostic risk factors - anxiety sensitivity (AS: fear of physiological anxiety or "fear of fear"; Reiss & McNally, 1985) and intolerance of uncertainty (IU; Buhr & Dugas, 2009) - in explaining relations between mental distress symptoms and behavioural responding during the COVID-19 pandemic. Student and community-based participants (N=457; 87.6% female) were recruited between May and July 2020 to complete measures of anxiety (health, panic, general), depression, and stress. Anxiety and related symptoms were found to be higher than in previous studies. Parallel mediation analyses showed that clinically meaningful levels of mental distress symptoms directly influenced safety behaviours and medical care utilization but also indirectly influenced the latter (vs. former) through AS-physical concerns (vs. IU). CBT interventions, targeting AS-physical concerns, may reduce mental distress symptoms during pandemic and prevent overuse of healthcare.

Keywords: Anxiety sensitivity; COVID-19; Intolerance of uncertainty; Medical care utilization; Panic.

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Conflict of interest statement

Conflict of InterestThe authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Conceptual model of multiple parallel mediation analyses. Note: Examining the direct effect of mental distress symptoms on COVID-19 safety behaviours and Medial Care Utilization (separately), as well as indirect effects via the physical concerns dimension of anxiety sensitivity and intolerance of uncertainty (adapted from Hayes, 2018)
Fig. 2
Fig. 2
Model of multiple parallel mediation analyses on COVID-19 safety behaviours. Note: Direct effect of mental distress symptoms and indirect effects via the physical concerns dimension of anxiety sensitivity and intolerance of uncertainty (adapted from Hayes, 2018)
Fig. 3
Fig. 3
Model of multiple parallel mediation analyses on medical care utilization. Note: Direct effect of mental distress symptoms on medical care utilization and indirect effects via the physical concerns dimension of anxiety sensitivity and intolerance of uncertainty (adapted from Hayes, 2018)
See this image and copyright information in PMC

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