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. 2022 Nov;72(6):100671.
doi: 10.1016/j.erap.2021.100671. Epub 2021 Jun 2.

Regulation strategies during COVID-19 quarantine: The mediating effect of worry on the links between coping strategies and anxiety

Clizia Cincidda  1   2 , Silvia Francesca Maria Pizzoli  1   2 , Serena Oliveri  1   2 , Gabriella Pravettoni  1   2
Affiliations

Regulation strategies during COVID-19 quarantine: The mediating effect of worry on the links between coping strategies and anxiety

Clizia Cincidda et al. Eur Rev Appl Psychol. 2022 Nov.

Abstract
in English, French

Introduction: The COVID-19 outbreak forced Italian citizens into a generalized quarantine from March to May 2020. The quarantine is a successful measure to reduce the virus's spread through physical and social distancing, but it can also have negative psychological consequences on the population. People experience high levels of worry and anxiety and have to cope with the consequences of the health emergency. The aim of this study was to preliminarily assess the causal relations among coping, worry and state anxiety at the time of COVID-19 first wave, and the mediation role of worry between coping and state anxiety.

Methods: During March 2020, 1273 Italian citizens completed an ad hoc online survey composed of sociodemographic and preoccupation-related questions, and standardized self-report questionnaire (Brief COPE, Penn State Worry Questionnaire and State-Trait Anxiety Inventory-State form). Three separate mediation models were performed.

Results: The relationship between coping strategies (i.e.: problem-focused coping, emotion-focused coping and dysfunctional coping) and state anxiety resulted to be mediated by worry. Dysfunctional and problem-focused coping had a negative effect on anxiety scores and this effect was amplified by high levels of worry. Emotion-focused coping reduced state anxiety scores through its effect on reducing the levels of worry, which in turn was related to a reduction in anxiety.

Conclusion: The present study offers first evidence for the mediation role of worry in the relation between coping and anxiety during quarantine caused by COVID-19 pandemic. It supports the clinical importance of investigating people's coping strategies along with the levels of (cognitive) worry and their long-term effects on the psychological well-being during the outbreak, in order to deliver adequate personalized interventions. Psychological support should enhance emotion-focused coping strategies that have a protective effect on both worry and anxiety.

Introduction: L’épidémie de COVID-19 a contraint les citoyens italiens à une quarantaine généralisée de mars à mai 2020. La quarantaine est une mesure efficace pour réduire la propagation du virus grâce à l’éloignement physique et social, mais elle peut également avoir des conséquences psychologiques négatives sur la population. Les gens éprouvent des niveaux élevés d’inquiétude et d’anxiété et doivent faire face aux conséquences de l’urgence sanitaire. Le but de cette étude a été d’évaluer de manière préliminaire les relations causales entre l’adaptation, l’inquiétude et l’anxiété d’état au moment de la première vague de COVID-19, et le rôle médiateur de l’inquiétude entre l’adaptation et l’anxiété d’état.

Méthodes: Au cours du mois de mars 2020, 1273 citoyens italiens ont rempli une enquête ad hoc en ligne composée de questions concernant des données socio-démographiques et liées aux préoccupations, et d’un questionnaire d’auto-évaluation standardisé (Brief COPE, Penn State Worry Questionnaire et State-Trait Anxiety Inventory, l’échelle d’anxiété – État). Trois modèles de médiation distincts ont été réalisés.

Résultats: La relation entre les stratégies d’adaptation (c’est-à-dire l’adaptation centrée sur le problème, l’adaptation centrée sur les émotions et l’adaptation dysfonctionnelle) et l’anxiété liée à l’état a été influencée par l’inquiétude. L’adaptation dysfonctionnelle et axée sur les problèmes a eu un effet négatif sur les scores d’anxiété et cet effet a été amplifié par des niveaux élevés d’inquiétude. L’adaptation axée sur les émotions a réduit les scores d’anxiété d’état par son effet sur la réduction des niveaux d’inquiétude, qui à son tour était liée à une réduction de l’anxiété.

Conclusion: La présente étude offre une première preuve du rôle médiateur de l’inquiétude dans la relation entre l’adaptation et l’anxiété pendant la quarantaine causée par la pandémie de COVID-19. Elle soutient l’importance clinique d’étudier les stratégies d’adaptation des personnes ainsi que les niveaux d’inquiétude (cognitive) et leurs effets à long terme sur le bien-être psychologique pendant l’épidémie, afin de fournir des interventions personnalisées adéquates. Le soutien psychologique devrait améliorer les stratégies d’adaptation axées sur les émotions qui ont un effet protecteur sur l’inquiétude et l’anxiété.

Keywords: Anxiety; COVID-19; Coping; Quarantine; Worry.

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Figures

Fig. 1
Fig. 1
Model of problem-focused coping as a predictor of State Anxiety, mediated by worry. The confidence interval for the indirect effect is a BCa bootstrapped CI based on 5000 samples. Total effect, c = .37, 95% CI [0.02, 0.27]. Note. The regression coefficient between coping and state anxiety, after controlling for worry, is reported in parenthesis.
Fig. 2
Fig. 2
Model of emotion-focused coping as a predictor of State Anxiety, mediated by worry. The confidence interval for the indirect effect is a BCa bootstrapped CI based on 5000 samples. Total effect, c = −.45, 95% CI [−.60, −30]. Note. The regression coefficient between coping and state anxiety, after controlling for worry, is reported in parenthesis.
Fig. 3
Fig. 3
Model of dysfunctional coping as a predictor of State Anxiety, mediated by worry. The confidence interval for the indirect effect is a BCa bootstrapped CI based on 5000 samples. Total effect, c = .94, 95% CI [.79, 1.08]. Note. The regression coefficient between coping and state anxiety, after controlling for worry, is reported in parenthesis.
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