The Path analysis model in prediction of corona phobia based on intolerance of uncertainty and health anxiety

Authors
susan Alizadeh fard
Ahmad Alipour
Payame Noor University
10.52547/rph.14.1.16
Abstract
The corona disease epidemic have had different effects on the social and psychological aspects of individuals. Studies show that with spread of disease, the fear of this is also increasing. The aim of this study was to investigate the relationship between intolerance of uncertainty and health anxiety with corona phobia in Tehran society. For this purpose, a sample of 430 adult men and women evaluated by health anxiety questionnaire (Salkovskis, 2002), intolerance of uncertainty (Freeston, 1994), and fear of corona (Griffiths & pakpour, 2020) through online recall and via social network. To analyze the data, Pearson correlation and path analysis were used. The results showed health anxiety and intolerance were positively and directly correlated with fear of corona. Also, intolerance to uncertainty was indirectly correlated with fear of corona through mediating of health anxiety. These results will have practical implications for controlling and reducing fear of corona and corona phobia. It is suggested that according to these personality and cognitive variables, they should be used to design psychological interventions to maintain and promote the mental health of the community in pandemic corona disease.
Keywords
corona phobia
intolerance of uncertainty
Health Anxiety
path analysis
WHO. Novel coronavirus (2019-nCoV) situation report - 15. Feb 4, 2020.https://www.who.int/docs/default-source/ coronaviruse/situation-reports/20200204- Sitrep 15 ncov.pdf? sfvrsn =88fe8ad6_2 (accessed Feb 4, 2020).
Alizadeh fard S. saffarinia M. The prediction of mental health based on the anxiety and the social cohesion that caused by Coronavirus. Res Soc Psychol 2020; 9(4): 129-141.
Coronavirus Disease 2019 (COVID-19) Symptoms. Centers for Disease Control and Prevention. United States. 10 February 2020. Archived from the original on 30 January 2020.
Kangxing Song, Tao Li, Dan Luo, Fengsu Hou, Fengying Bi, Terry D. Stratton, Voyko Kavcic, Rong Jiao, Rui Xu, Shiyan Yan, Yang Jiang. medRxiv 2020.04.29.20084061; doi: https://doi.org/10.1101/2020.04.29.20084061
Angus Reid Institute. Half of Canadians taking extra precautions as coronavirus continues to spread around the globe. Retrieved February 6, 2020 http://angusreid.org/ wp-content/uploads/2020/02/2020.02.04_Coronavirus.pdf.
National Public Radio. Poll: Most Americans say U.S. “doing enough” to prevent coronavirus spread. Retrieved February 6, 2020 https://www.npr.org/sections/healthshots/ 2020/02/04/802387025/poll-most-americans-say-u-s-doing-enough-toprevent- coronavirus-spread.
Van den Bulck J, Custers K. Television exposure is related to fear of avian flu, an Ecological Study across 23 member states of the European :union:. Eur J Public Health. 2009; 19(4): 370–374. Published online 2009 May 18. doi: 10.1093/eurpub/ckp061
McDonnell W M, Nelson D S, & Schunk J E. Should we fear “flu fear” itself? Effects of H1N1 influenza fear on ED use. Am J Emerg Med 2012; 30: 275– 282.
Rubin G J, Amlot R, Page L, & Wessely S. Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: Cross sectional telephone survey. B M J 2009; 339, b2651.
Kanadiya M K, & Sallar A M. Preventive behaviors, beliefs, and anxieties in relation to the swine flu outbreak among college students aged 18-24 years. J Public Health 2011; 19(2): 139-145. doi:10.1007/s10389-010-0373-3
CHENG S, WONG C, TSANG J, & WONG K. Psychological distress and negative appraisals in survivors of severe acute respiratory syndrome (SARS). Psychol Med 2004; 34(7): 1187-1195. doi:10.1017/S0033291704002272
Taylor S. The psychology of pandemics: Preparing for the next global outbreak of infectious disease. Newcastle upon Tyne 2019: Cambridge Scholars Publishing.
Bhatia MS, Goyal S, Singh A, et al. COVID-19 pandemic–induced panic disorder. Prim Care Companion CNS Disord. 2020; 22(3): 20l02626.
Tyrer P, Tyrer H. Health anxiety: detection and treatment. B J Psych Advances. Cambridge University Press; 2018; 24(1):66–72.
Stein D J, Kogan C S, Atmaca M, et al. The classification of obsessive-compulsive and related disorders in the ICD-11. J Affect Disord 2016; 190: 663–74.
Taylor M, Petrakis I, Ralevski E. Treatment of alcohol use disorder and co-occurring PTSD. Am J Drug Alcohol Abuse. 2017; 43(4):391-401. doi: 10.1080/00952990.2016.1263641.
Taylor S, & Asmundson G J G. Treating health anxiety: A cognitive-behavioral approach. New York 2004: Guilford.
Gordon J G, Asmundson, Steven Taylor, Coronaphobia: Fear and the 2019-nCoV outbreak, J Anxiety Disord 2020; 70:102196. https://doi.org/10.1016/j.janxdis.2020.102196.
Lowen M. Coronavirus: Chinese targeted as Italians panic. BBC News. Retrieved February 8, 2020 https://www.bbc.com/news/world-europe-51370822.
Lin C Y. Social reaction toward the 2019 novel coronavirus (COVID-19). Soc Health Behav 2020; 3(1): 1–2. https://doi.org/10.4103/SHB.SHB_11_20.
Guan W J, Ni Z Y, Hu Y, Liang W H, Ou C Q, He J X, ... & Du B. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020; 1708-1720. https://doi.org/10.1056 /NEJMoa2002032.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The Lancet 2020; 395(10223): 497–506. https://doi.org/10.1016/S0140- 6736(20)30183-5.
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA 2013: American Psychiatric Publishing.
Asmundson G J G, Taylor S. How health anxiety influences responses to viral outbreaks like COVID-19: What all decision-makers, health authorities, and health care professionals need to know. J Anxiety Disord 2020; 71: 102211. ISSN 0887-6185, https://doi.org/10.1016/j.janxdis.2020.102211. (http://www.sciencedirect.com/science/article/pii/S0887618520300256).
Adalja A A, Toner E, & Inglesby T V. Priorities for the US health community responding to COVID-19. JAMA 2020; 323(14):1343-1344. https://doi.org/10.1001/jama.2020.3413.
Pappas G, Kiriaze I J, Giannakis P, & Falagas M E. Psychosocial consequences of infectious diseases. Clin Microbiol Infect 2009; 15(8): 743–747. https://doi.org/10.1111/j.1469- 0691.2009.02947.x.
Dugas M J, Freeston M H, & Ladouceur R. Intolerance of uncertainty and problem orientation in worry. Cognit Ther Res 1997; 21: 593–606.
American Psychiatric Association. Diagnostic and sta‌tistical manual for mental disorders (4th ed). Washington, D.C. 1994; American Psychiatric Association.
Dugas M J, Schwartz A, & Francis K. Intolerance of uncertainty, worry, and depression. Cognit Ther Res 2004; 28: 835–842.
Bottesi G, Ghisi M, Carraro E, Barclay N, Payne R and Freeston MH. Revising the Intolerance of Uncertainty Model of Generalized Anxiety Disorder: Evidence from UK and Italian Undergraduate Samples. Front Psychol 2016; 7: 1723. doi: 10.3389/fpsyg.2016.01723.
Freeston M H, Rheaume J, Letarte H, Dugas M J, Ladou‌ceur R. Why do people worry? Pers Indi‌vid Dif 1994; 17(6): 791-802.
Mahoney A E J, & McEvoy P M. Changes in intol‌erance of uncertainty during cognitive behaviour group therapy for social phobia. J Behav Ther Exp Psychiatry 2012; 43(2): 849-854.
kazemi R A, Saeedpoor S, samimi Z, Parooi M, Afzoon J. The Comparison of the Intolerance of Uncertainty and Short-Term Memory Capacity in Patients with Obsessive Compulsive Disorder and Normal Individuals. J C P 2017; 5 (3): 61-70, [Persian].
URL: http://jcp.khu.ac.ir/article-1-2620-fa.html
Nolen-Hoeksema S. The role of rumination in depressive disorders and mixed anxiety/depressive symptom. J Abnorm Psychol 2000; 109(3): 504- 511.
McEvoy P M, & Mahoney A E J. To be sure, to be sure: Intolerance of uncertainty mediates symptoms of vari‌ous anxiety disorders and depression. Behav Ther 2012; 43(3): 533-545.
O’Bryan E M, McLeish A C. An Examination of the Indirect Effect of Intolerance of Uncertainty on Health Anxiety through Anxiety Sensitivity Physical Concerns. J Psychopathol Behav 2017; 39: 715–722. https://doi.org/10.1007/s10862-017-9613-y
Fergus T A, Bardeen J R. Anxiety sensitivity and intolerance of uncertainty: Evidence of incremental specificity in relation to health anxiety, Pers Individ Dif 2013; 55 (6): 640-644. ISSN 0191-8869, https://doi.org/10.1016/j.paid.2013.05.016.
Wright D K, Adams Lebell M A N, Carleton R N. Intolerance of uncertainty, anxiety sensitivity, health anxiety, and anxiety disorder symptoms in youth. J Anxiety Disord 2016; 41: 35-42. ISSN 0887-6185, https://doi.org/10.1016/j.janxdis.2016.04.011.
Asmundson G J G, Abramowitz J, Richter A A, & Whedon M. Health anxiety: Current perspectives and future directions. Curr Psychiatry Rep 2010; 12: 306–312.
Salkovskis P M, Warwick H M C. Morbid preoccupations, health anxiety and reassurance: a cognitive-behavioral approach to hypochondriasis. Behav Res Ther 1986; 24:597–602.
Cooper K, Gregory J D, Walker I, Lambe S, Salkovskis PM. Cognitive Behaviour Therapy for Health Anxiety: A Systematic Review and Meta-Analysis. Behav Cogn Psychother 2017; 45(2): 110–23.
Ahorsu D K, Lin C, Imani V, Saffari M, Griffiths M D, Pakpour A H. The Fear of COVID-19 Scale: Development and Initial Validation. Int J Ment Health Addiction 2020. https://doi.org/10.1007/s11469-020-00270-8.
Salkovskis P M, Rimes K A, Warwick H M C, & Clark D M. The Health Anxiety Inventory: development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychol med 2002; 32(5): 843-853.
Nargesi F, Izadi F, Kariminejad K, Rezaiisharif A. The investigation of the reliability and validity of Persian version of Health anxiety questionnaire in students of Lorestan University of Medical Sciences. Q Educ Meas 2017; 7(27): 147-160, [Persian]. doi: 10.22054/jem.2017.19621.1495
Freeston MH, Rhéaume J, Letarte H, Dugas MJ, Ladouceur R. Why do people worry? Personal Individ Differ 1994; (17): 791–802.
Buher K, Dugas MJ. Investigation the construct validity of intolerance of uncertainly and its unique relationship with worry. J Anxiety Disorder 2006; 20: 223-234.
Ebrahimzadeh Z. The study of cognitive beliefs, perfectionism and social problem solving ability according to uncertainty levels among OCD and MDD. Dissertation in MA 2006; Ardabil University, [Persian].
Kosic A, Lindholm P, Jarvholm K, Hedman-Lagerlof E, & Axelsson E. Three decades of increase in health anxiety: Systematic review and meta-analysis of birth cohort changes in university student samples from 1985 to 2017. J Anxiety Disord 2020; 71: 102208. https://doi.org/10.1016/j.janxdis.2020.102208.
Dugas M J, Schwartz A & Francis K. Brief Report: Intolerance of Uncertainty, Worry, and Depression. Cogn Ther Res 2004; 28: 835–842. https://doi.org/10.1007/s10608-004-0669-0
Asadi S, Abedini M, Poursharifi H, Nikokar M. The Relationship between Intolerance of Uncertainty and Rumination with Worry on Student Population. J Clin Psychol 2012; 4(4): 83-92. doi: 10.22075/jcp.2017.2110