The relationship between fear of COVID‐19 and health anxiety among families with COVID‐19 infected: The mediating role of metacognitions, intolerance of uncertainty and emotion regulation

Abstract

The current study aimed to investigate the mediating role of metacognitions, intolerance of uncertainty and emotion regulation in the relationship between fear of COVID‐19 (FC‐19) and health anxiety, among families with COVID‐19 infected. Participants were 541 individuals from family members of patients with COVID‐19 (F = 52.3%, mean age = 41.3 ± 13.2 years). Data were collected with a packet including sociodemographic and risk factors, the Fear of COVID‐19 Scale, the Short Health Anxiety Inventory, the Metacognitions Questionnaire 30, the Intolerance of Uncertainty Scale‐12 and the Emotion Regulation Questionnaire. Structural equation modelling analyses revealed a full mediation of metacognitions (i.e., positive beliefs about worry, negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence and beliefs about the need to control thoughts), intolerance of uncertainty and expressive suppression in the relation between FC‐19 and health anxiety. Moreover, the strongest indirect links were found between FC‐19 and health anxiety through negative beliefs about thoughts concerning uncontrollability and danger and intolerance of uncertainty. These associations were independent of gender and risk status. The final model accounted for 71% of the variance of health anxiety. These findings suggest that particularly metacognitions, intolerance of uncertainty and expressive suppression play a full mediational role in the relation between FC‐19 and health anxiety.

The Italian COVID‐19 Anxiety Syndrome Scale: Investigation of the COVID‐19 anxiety syndrome and its association with psychological symptoms in an Italian population

“…The COVID‐19 pandemic and the consequent containment measures have quickly and abruptly changed people's customary life (Alzueta et al, 2021 ; Busch et al, 2021 ; Emmelkamp, 2021 ). A key change brought by the pandemic has been a worldwide increase of pandemic‐related psychological distress, including fear, worry, persistent avoidance, affective symptoms, posttraumatic stress symptoms, substance abuse, somatization, allostatic load, abnormal illness behaviour, fatigue, loneliness and violent behaviours, among the general population as well as the most vulnerable subgroups, including healthcare workers, older people and psychiatric patients (Amsalem et al, 2021 ; Akbari, Spada, et al, 2021 ; Brailovskaia et al, 2021 , 2021 ; Busch et al, 2021 ; Cosci & Guidi, 2021 ; Davis et al, 2021 ; Emmelkamp, 2021 ; Fitzpatrick et al, 2020 ; Lebrasseur et al, 2021 ; Mansueto et al, 2021 ; Peng et al, 2021 ; Taylor et al, 2021 ; Zhang et al, 2020 ). Moreover, it has been suggested that the COVID‐19 pandemic may have also exacerbated dysfunctional coping strategies in response to fear or threat of the COVID‐19 pandemic itself, such as avoidant behaviours, checking, worrying and threat monitoring (Nikčević et al, 2021 ; Nikčević & Spada, 2020 ).…”

The Persian COVID‐19 Anxiety Syndrome Scale (C‐19ASS): Psychometric properties in a general community sample of Iranians

“…From the beginning of the COVID‐19 outbreak, people have experienced elevated psychological distress in their everyday lives (e.g., Akbari, Seydavi, et al, 2021 ; Brailovskaia et al, 2021 ; Cao et al, 2020 ; Chen et al, 2021 ; Duong, 2021 ; Kontoangelos et al, 2020 ; Lee, 2020 ; Mansueto et al, 2021 ; Shevlin et al, 2020 ) including depression and anxiety (Huang & Zhao, 2020 ; Oh et al, 2021 ; Wierenga et al, in press ), obsessive–compulsive symptoms (Abba‐Aji et al, 2020 ; Seçer & Ulaş, 2020 ; Wheaton et al, 2021 ), substance use (Akbari et al, 2020 ; Czeisler et al, 2020 ), post‐traumatic stress symptoms (Akbari, Hosseini, et al, 2021 ; Johnson et al, 2020 ; Liu et al, 2020 ), suicidal ideation (Czeisler et al, 2020 ), health anxiety (Akbari, Spada, et al, 2021 ; Özdin & Özdin, 2020 ), psychological distress (Wang et al, 2020 ; Wu et al, 2020 ), hopelessness (Hacimusalar et al, 2020 ), loneliness and fatigue (Hou et al, 2020 ; Mansueto et al, 2021 ), loss and grief (Wallace et al, 2020 ; Zhai & Du, 2020 ), sleep problems (Duong, 2021 ; Jahrami et al, 2021 ) and reduced life satisfaction (Duong, 2021 ).…”

Interoceptive anxiety-related processes: Importance for understanding COVID-19 and future pandemic mental health and addictive behaviors and their comorbidity

“…Similarly, Wu, Nazari, and Griffiths (2021) also found a significant cross-sectional mediational effect for global anxiety sensitivity and intolerance of uncertainty on the independent relations between COVID-19 fear and COVID-19 anxiety with cyberchondria (i.e., anxiety resulting from a health-related search online; Starcevic & Berle, 2013 ; Starcevic & Berle, 2015 ) among 649 adults in Iran. Akbari, Spada, Nikčević, and Zamani (2021) reported that among a sample of adults in Tehran ( n = 541) who had family members infected with COVID-19, cross-sectional analysis revealed several individual risk vulnerabilities, including facets of metacognitions (e.g., positive beliefs about worry, negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence, and beliefs about the need to control thoughts), intolerance of uncertainty, and expressive suppression (a facet of emotion regulation), mediated the relationship between COVID-19 fear and health anxiety. The cumulative effect of COVID-19 risk factors, including COVID-19 worry and alcohol use motives to cope with the pandemic, served as serial mediators for the relation for greater emotion regulation specific to goal directed behavior and higher estimated Blood Alcohol Level (BAC) levels among 347 college students in the U.S. ( Buckner et al, 2021 ).…”