The mediating role of coping styles in the relationship between COVID-19 anxiety and health anxiety

Document Type : Original Article

Authors

Department of Clinical Psychology, Kashan University of Medical Sciences, Kashan, Iran

Abstract

Objectives: This study aims to investigate the mediating effect of coping styles on the relationship between anxiety triggered by COVID-19 and health-related anxiety in the general population of Kashan city during the COVID-19 pandemic.
Methods: A cross-sectional online questionnaire was used to collect data from 390 participants in Kashan, Iran, between March and April 2020, during the peak of the pandemic. Participants were recruited through snowball sampling. The assessment tools included the Short Health Anxiety Inventory (SHAI), COVID-19 Anxiety Scale, Coping Responses Inventory (CRI), and Body Vigilance Scale (BVS). Descriptive and correlation analyses were performed using SPSS-22, and structural equation modeling (SEM) was conducted with Amos-22 software to analyze the mediating role of coping styles.
Results: The Pearson correlation results revealed that problem-solving, social support, and cognitive reappraisal were negatively associated with health anxiety, while emotion-focused and somatization coping strategies were positively associated with health anxiety symptoms (p < .05). The SEM analysis showed that cognitive reappraisal acted as a negative mediator in the relationship between COVID-19 anxiety and health anxiety.
Conclusions: Our findings support previous research indicating that emotion-focused coping strategies can exacerbate anxiety levels. Additionally, we found that cognitive reappraisal may serve as a protective factor in mitigating the transition from COVID-19 anxiety to health anxiety.

Keywords

Main Subjects

References

  1. Ai T, Yang Z, Hou H, Zhan C, Chen C, Lv W, et al. Correlation of chest CT and RT-PCR testing for coronavirus disease 2019 (COVID-19) in China: a report of 1014 cases. Radiology. 2020;296 (2):E32-40. doi:10.1148/radiol.2020200642 PMid:32101510 PMCid:PMC7233399
  2. "Coronavirus". https://www.worldometers.info/coronavirus/country/iran/
  3. Rosenbaum L. Facing Covid-19 in Italy-ethics, logistics, and therapeutics on the epidemic's front line. N Engl J Med. 2020; 382 (20):1873-5. doi:10.1056/NEJMp2005492 PMid:32187459
  4. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health. 2020;17(5):1729. doi:10.3390/ijerph17051729 PMid:32155789 PMCid:PMC7084952
  5. Zhang Y, Ma ZF. Impact of the COVID-19 pandemic on mental health and quality of life among local residents in Liaoning Province, China: A cross-sectional study. Int J Environ Res Public Health. 2020;17(7):2381. doi:10.3390/ijerph17072381 PMid:32244498 PMCid:PMC7177660
  6. Benke C, Schönborn T, Habermann N, Pané-Farré CA. Health anxiety is associated with fearful imagery of contracting COVID-19: An experimental study. J Affect Disord. 2022;298: 316-21. doi:10.1016/j.jad.2021.11.014 PMid:34763031 PMCid:PMC8574074
  7. Qian M, Wu Q, Wu P, Hou Z, Liang Y, Cowling BJ, et al. Psychological responses, behavioral changes and public perceptions during the early phase of the COVID-19 outbreak in China: a population based cross-sectional survey. MedRxiv. 2020: 2020-02. doi:10.1101/2020.02.18.20024448
  8. Tran B, Allnutt A, Wong A. COVID-19 pandemic and youth fitness: a systematic review. Novel Clin Med 2023;2(1):3-10. doi: 10.22034/ncm.2023.381863.1069
  9. Becheva MS, Kirkova-Bogdanova AG, Atanasov PJ, Chaneva MS, Taneva DI, Ivanova SA. Monitoring the change in the quality of life of patients with post-COVID syndrome by influence on their functional status. Pharmacia. 2023;70(4):1111-7. doi:10.3897/pharmacia.70.e113061
  10. Manchia M, Gathier AW, Yapici-Eser H, Schmidt MV, de Quervain D, van Amelsvoort T, et al. The impact of the prolonged COVID-19 pandemic on stress resilience and mental health: A critical review across waves. Eur Neuropsychopharmacol. 2022; 55:22-83. doi:10.1016/j.euroneuro.2021.10.864 PMid:34818601 PMCid:PMC8554139
  11. Salmani B, Hasani J, Zanjani Z, Gholami-Fesharaki M. Two Years after the Beginning of COVID-19: Comparing Families Who Had or Did not Have Patients with COVID-19 on Health Beliefs and Obsessive-Compulsive Symptoms. Iran J Psychiatry. 2023;18 (4): 429. doi:10.18502/ijps.v18i4.13630 PMid:37881416 PMCid:PMC10593991
  12. Salmani B, Hasani J, Zanjani Z. Comparing individuals with Obsessive-Compulsive Disorder (OCD) and Panic Disorder (PD), with nonclinical population on obsessive beliefs and COVID-19 stress two years after the beginning of the pandemic. J Res Behav Sci. 2022;20(1):98-112. doi:10.52547/rbs.20.1.98
  13. Abramowitz JS, Braddock A. Psychological treatment of health anxiety and hypochondriasis: A biopsychosocial approach. Hogrefe Publishing GmbH; 2008.
  14. Asmundson G, Abramowitz J, Richter AA, Whedon M. Health anxiety: Current perspectives and future directions. Curr Psychiatry Rep. 2010;12:306-312. doi:10.1007/s11920-010-0123-9 PMid:20549396
  15. Olatunji BO, Deacon BJ, Abramowitz JS, Valentiner DP. Body vigilance in nonclinical and anxiety disorder samples: structure, correlates, and prediction of health concerns. Behav Ther. 2007; 38 (4):392-401. doi:10.1016/j.beth.2006.09.002 PMid:18021953
  16. Williams PG. The psychopathology of self-assessed health: A cognitive approach to health anxiety and hypochondriasis. Cogn Ther Res. 2004;28:629-44. doi:10.1023/B:COTR.0000045569.25096.44
  17. Miri M, Nordvall M, Wong A, Zarei S. Comparing road traffic accident and COVID-19 casualties in Iran: A call to action. Arch Trauma Res 2023; 12(3): 169-170. doi: 10.48307/atr.2023.419936.1037
  18. Görgen SM, Hiller W, Witthöft M. Health anxiety, cognitive coping, and emotion regulation: A latent variable approach. Int J Behav Med. 2014;21:364-74. doi:10.1007/s12529-013-9297-y PMid:23436185
  19. Fergus TA, Valentiner DP. Disease phobia and disease conviction are separate dimensions underlying hypochondriasis. J Behav Ther Exp Psychiatry. 2010;41(4):438-44. doi:10.1016/j.jbtep.2010.05.002 PMid:20627267
  20. Garnefski N, Kraaij V, Spinhoven P. Negative life events, cognitive emotion regulation and emotional problems. Personal Individ Differ. 2001;30(8):1311-27. doi:10.1016/S0191-8869(00)00113-6
  21. Mohammadinia N, Rezaei M, Heydarikhayat N, Sharifipoor H, Darban F. Assessing stressors and coping styles in medical sciences students. QJ Nurs Manag. 2012;1(1):9-16.
  22. Taha S, Matheson K, Cronin T, Anisman H. Intolerance of uncertainty, appraisals, coping, and anxiety: The case of the 2009 H1N1 pandemic. Br J Health Psychol. 2014; 19(3):592-605. doi:10.1111/bjhp.12058 PMid:23834735
  23. Panahi S, Asghari Moghadam MA, Shaeeri MR, Eghtedar Nejhad S. Psychometric properties of a Persian version of the short form of health anxiety inventory in non-clinical Iranian populations. Q Educat Meas. 2010;1(2):21-46.
  24. Moos RH. Coping responses inventory: CRI from adults. Psychological assessment resources, Professional manual, Odessa, TX. 1993.
  25. Hosseini Ghadamgahi J. Investigation of association of stress, coping strategies and quality of relationship with coronary heart disease. 1997. (Doctoral dissertation, MA. Dissertation. Tehran: Iran University of Medical Sciences, Tehran Psychiatric Institute, 101-2.
  26. Bernstein A, Zvolensky MJ, Sandin B, Chorot P, Stickle TR. Body vigilance: bi‐national examination of the construct. Depress Anxiety. 2008;25(10):E81-91. doi:10.1002/da.20330 PMid:17405161
  27. Bentler PM. Comparative fit indexes in structural models. Psychol Bull. 1990 107(2): 238 doi:10.1037//0033-2909.107.2.238 PMid:2320703
  28. Ghazanfarpour M, Ashrafinia F, Zolala S, Ahmadi A, Jahani Y, Hosseininasab A. Investigating the effectiveness of tele-counseling on mental health of staff in coronavirus reference clinics and hospitals. Available at SSRN 3572898. 2020. doi:10.2139/ssrn.3572898
  29. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020; 395 (10227):912-20. doi:10.1016/S0140-6736(20)30460-8 PMid:32112714
  30. Alizadehfard S, Alipour A. The path analysis model in prediction of corona phobia based on intolerance of uncertainty and health anxiety. J Res Psychol Health. 2020;14(1):16-27.
  31. Seligman ME, Rashid T, Parks AC. Positive psychotherapy. Am Psychol. 2006;61(8):774. doi:10.1037/0003-066X.61.8.774 PMid:17115810
  32. Saeedi M, Abedini Z, Latif M, Piruzhashemi M. Correlation between COVID-19-related health anxiety and coping styles among frontline nurses. BMC Nurs. 2023;22(1):238. doi:10.1186/s12912-023-01344-3 PMid:37430210 PMCid:PMC10332006
  33. Amani M, Ghodrati S. The mediating role of coping strategies in the relationship between personality traits and perceived stress with health anxiety during the COVID-19 pandemic. J Fundament Ment Health. 2023;25(3).
  34. Yıldırım M, Akgül Ö. Geçer E. The Effect of COVID-19 Anxiety on General Health: the Role of COVID-19 Coping. Int J Ment Health Addic 20, 1110-1121 (2022). doi:10.1007/s11469-020-00429-3 PMid:33456406 PMCid:PMC7799156
  35. Yue XG, Shao XF, Li RY, Crabbe MJ, Mi L, Hu S, et al. Risk management analysis for novel coronavirus in Wuhan, China. J Risk Financ Manag. 2020;13(2):22. doi:10.3390/jrfm13020022
International Archives of Health Sciences
Volume 11, Issue 1
February 2024
Pages 42-48

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History

  • Receive Date: 13 September 2023
  • Revise Date: 18 November 2023
  • Accept Date: 02 December 2023

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