Increased anxiety of public situations during the COVID-19 pandemic: Evidence from a community and a patient sample

Abstract

Background Increases in emotional distress in response to the global outbreak of the SARS-CoV-2 (COVID-19) pandemic have been reported. So far, little is known about how anxiety responses in specific everyday public life situations have been affected. Method Self-reported anxiety in selected public situations, which are relevant in the COVID-19 pandemic, was investigated in non-representative samples from the community (n = 352) and patients undergoing psychotherapy (n = 228). Situational anxiety in each situation was rated on a 5-point Likert scale (0 = no anxiety at all to 4 = very strong anxiety). Situational anxiety during the pandemic was compared with retrospectively reported situational anxiety before the pandemic (direct change) and with anxiety levels in a matched sample assessed before the pandemic (n = 100; indirect change). Results In the community and patient sample, indirect and direct change analyses demonstrated an increase in anxiety in relevant public situations but not in control situations. Average anxiety levels during the pandemic were moderate, but 5-28% of participants reported high to very high levels of anxiety in specific situations. Interestingly, the direct increase in anxiety levels was higher in the community sample: patients reported higher anxiety levels than the community sample before, but not during the pandemic. Finally, a higher increase in situational anxiety was associated with a higher perceived danger of COVID-19, a higher perceived likelihood of contracting COVID-19, and stronger symptoms of general anxiety and stress. Conclusions Preliminary findings demonstrate an increase in anxiety in public situations during the COVID-19 pandemic in a community and a patient sample. Moderate anxiety may facilitate compliance with public safety measures. However, high anxiety levels may result in persistent impairments and should be monitored during the pandemic.

A network perspective on real‐life threat, anxiety, and avoidance

“…Situation‐specific anxiety and approach‐avoidance motivation were assessed in respect to four public situations assumed to pose a realistic threat during the COVID‐19 pandemic. These situations were: “Going to a supermarket,” “Staying in a crowded public area,” “Taking a bus,” and “Talking to others.” We previously reported an increase in situational anxiety for each of these situations, supporting their utility as a paradigmatic model for naturalistic threat situations during the COVID‐19 pandemic (Pittig, Glück, et al, 2021). For each of these four situations, the participants rated (a) their situational anxiety in the previous 2 weeks (5‐point Likert scale: 0 = no anxiety at all to 4 = very strong anxiety ), (b) their motivation to avoid the situation (5‐point Likert scale: 0 = not at all , 4 = very strongly ), (c) their motivation to approach the situation (5‐point Likert scale: 0 = not at all , 4 = very strongly ), (d) whether they expected positive consequences of approaching the situation (5‐point Likert scale: 0 = not at all , 4 = very strongly ), and, finally, (e) the actual frequency of avoiding the situation in the previous 2 weeks (5‐point Likert scale: 0 = very rarely , 4 = very often ).…”

“…First, some items, including the items for situation‐specific anxiety, approach and avoidance motivation, and the items assessing avoidance frequency were not validated in an independent sample due to limited time (i.e., to hold the degree of COVID‐19‐related restrictions as comparable as possible). Similar rating scales are, however, frequently used in psychological research, and most assessed situations were part of established questionnaires (for more details, see Pittig, Glück et al, 2021). Second, the patient subsample was characterized by a current mental health condition, but specific diagnoses were not assessed to protect the patients' rights of privacy and anonymity, thereby not allowing us to examine specific disorders.…”

“…The online survey (for a detailed description see Pittig, Glück, et al, 2021) included (a) basic sociodemographic variables (i.e., age, sex, employment status), (b) measures of trait anxiety, (c) general symptoms of anxiety, stress, and depression, (d) COVID‐19 related variables (risk group status, perceived dangerousness of COVID‐19, perceived risk of infection), and (e) situation‐specific variables (anxiety, approach and avoidance motivation, and avoidance frequency) towards four specific public situations relevant to the pandemic.…”

Mental health improvement after the COVID-19 pandemic in individuals with psychological distress

“…Also at jeopardy were people with financial insecurity 13,14,16 and inadequate physical space during periods of lockdown isolation 17 . Moreover, individuals with a COVID-19 diagnosis within their social environment during the first wave 18 or those who perceived the danger of COVID-19 to be higher 19 reported elevated anxiety during the pandemic. On the other hand, social contacts (especially offline but also online) were identified as a buffer against deprivations of mental health 16,17 because they reduce loneliness 20,21 .…”

“…Adverse effects of the COVID-19 pandemic on mental health were particularly pronounced in individuals who already suffered from mental impairments before the outbreak of the pandemic 11,13,15 . For example, a lack of exposure to social situations may have contributed to the maintenance of symptomatology within individuals suffering from social anxiety 19,23,24 . Previous experiences of childhood trauma and other threatening events can also increase an individual's vulnerability for the negative effects of subsequent adverse events 25,26 such as the COVID-19 pandemic 27,28 .…”