The Mediating Effects of Fear of COVID-19 and Depression on the Association Between Intolerance of Uncertainty and Emotional Eating During the COVID-19 Pandemic in Turkey

The impact of COVID-19 fear during the later stages of the pandemic on maladaptive eating, psychological distress and body weight: a global cross-sectional study

BACKGROUND

The COVID-19 pandemic significantly impacted global mental health, leading to increased levels of fear, stress, and anxiety [1]. Previous research has suggested associations between functional fear of detrimental mental health outcomes and psychological stressors which may drive maladaptive eating behaviors. This study explored the associations between COVID-19 fear during later stages of the pandemic, psychological distress (anxiety, depression, and stress), maladaptive eating behaviors (emotional, uncontrolled, binge, and nighttime eating), and self-reported body weight.

METHODS

This was a global cross-sectional survey conducted from February 2022 to February 2024, involving 4390 adults (70% female) from 25 countries. The survey collected information on demographics, psychosocial impact, eating behaviors, and COVID-19 related behaviors. General linear models, multinomial logistic regression modes, and structural equation modeling were used to analyze the data.

RESULTS

Higher fear of COVID-19 was significantly associated with increased emotional and uncontrolled eating, even after adjusting for psychological distress and other covariates. Specifically, each unit increase in fear of COVID-19 scores was associated with a corresponding increase in emotional eating (β = 0.018) and uncontrolled eating (β = 0.029) behaviors (p-values < 0.0001). Furthermore, fear of COVID-19 was linked to higher odds of engaging in binge eating (OR = 1.05, 95% CI: 1.03, 1.07, p-value < 0.0001) and nighttime eating behaviors (OR = 1.04, 95% CI: 1.03, 1.06, p-value < 0.0001) in models adjusted for covariates; however, these associations were no longer significant when psychological distress variables were included. Fear of COVID-19 was also associated with body weight (β = 0.18) and BMI (β = 0.08) even with adjustments of covariates and psychological distress variables (p-values < 0.01). Structural equation modeling showed that fear of COVID-19 was related to current body weight through its impact on psychological distress and maladaptive eating behaviors.

CONCLUSIONS

Maladaptive eating behaviors influenced by the psychological distress experienced during the COVID-19 pandemic have persisted into the later stages of the pandemic. These results underscore an interconnectedness between functional fear and its influence on maladaptive eating behaviors and body weight. Understanding this link is crucial and has the potential to inform the development of public health policies.

TRIAL REGISTRATION

Clinical Trials.gov NCT04896060 Date of Registration: May 21, 2021.

More than meets the eyes: How can healthiness perceptions and restraint shape the purchase intent of food with nutrition claims?

The main goal of this study was to verify relationships between cognitive restraint, priorities in food choice, consumer perceptions, and engagement in slimming process, on willingness to buy foods with nutrition claims (NC). Online questionnaires were answered by 454 consumers over 18 years of age. Cognitive restraint, uncontrolled eating and emotional eating were measured by the Three-Factor Eating Questionnaire-R21. The Eating Motivation Survey was applied to evaluate food choice motives. Consumers' willingness to buy and perceived healthiness were assessed by structured scales. A structural equation model using partial least squares was used to evaluate the impact of different factors on willingness to buy foods with NC. Perceived healthiness impacted positively willingness to buy all foods with NC. Natural concerns had a positive impact on willingness to buy sugar-free chocolate, no sugar added paçoca (peanut sweet), high-protein yoghurt, high-fibre crackers, lactose-free milk and gluten-free bread. Cognitive restraint and engagement in a slimming process positively impacted willingness to buy sugar-free chocolate, high-protein yoghurt, gluten-free bread and light requeijão (Type of cream cheese). Yet, weight control concerns in food choices had a positive impact on willingness to buy light requeijão, high-protein yogurt, no sugar added paçoca and sugar-free chocolate. However, health concerns negatively impacted willingness to buy gluten-free bread, lactose-free milk and high-fibre crackers. The consequences of such perceptions and related factors on food choice and consumption are discussed. The present findings highlight the importance of extending the discussion on food labelling, as well as the careful regulation of the presence of NCs in ultra-processed foods.

Sex-related differences in eating behaviors during COVID-19 pandemic: A systematic review with metanalysis

Eating behavior can be influenced by external factors; however, there is no consensus on the existence of differences in eating behavior between the sexes in stressful situations, such as the COVID-19 pandemic. This systematic review assessed whether there was a difference in eating behavior between sexes during the COVID-19 pandemic. A search of nine databases (Medline/Pubmed, Embase, Scielo, VHL, Scopus, PsycINFO, Web of Science, ProQuest, Google Scholar) was conducted in October 2023. Studies reporting eating behaviors in males and females during the COVID-19 pandemic were included. Methodological quality was assessed using the Joanna Briggs Institute Critical Appraisal Instrument. Stratified meta-analyses were conducted using the STATA software. Of the 2388 studies identified, 45 were included in the qualitative synthesis, and 36 in the meta-analysis, encompassing a total of 35,792 participants. Validated questionnaires were used to assess eating behavior, including the TFEQ (33.3%), DEBQ (24.4%), EEQ (22.2%), EES (11.1%), EOQ-5 (2.2%), AEBQ (2.2%), EAS (2.2%), and EMAQ (2.2%). Overall, males exhibited lower scores in emotional eating (Cohen's d = -0.32, 95%CI: 0.46 to -0.17) and restrained eating (Hedges'g = -0.11, 95%CI: 0.16 to -0.06) compared to females. However, the subgroup analysis indicated no differences in emotional eating (subgroup difference p = 0.39) or restrained eating (subgroup difference p = 0.30) according to the year of pandemic. These findings underscore the importance of sex-specific interventions, the address eating behaviors during periods of heightened insecurity in worldwide health emergencies, such as the COVID-19 pandemic. Additionally, our results emphasize the necessity for public health strategies to monitor and promote healthy eating behaviors to mitigate their impact on overall health outcomes, even in males, as their eating behavior may be affected over the course of a global health crisis, as well as females.

Impact of Intolerance of Uncertainty on Depression in College Students During the COVID-19 Pandemic: Coping Strategies as Mediators

The coronavirus disease (COVID-19) pandemic and associated infection control measures have introduced significant uncertainty, and the unbearable nature of this uncertainty has heightened the risk of mental health issues among college students. This study aimed to assess the impact of unbearable uncertainty during the COVID-19 pandemic on college students' depression and investigate the mediating role of coping strategies between unbearable uncertainty and depression. A cross-sectional survey was conducted with 714 Chinese university students using the Intolerance of Uncertainty Scale (IUS-12), Brief Coping Style Questionnaire, and Beck Depression Inventory (BDI-II). SPSS PROCESS was used for the partial correlation analyses and structural equation modeling. (1) Negative coping strategies were significantly positively correlated with intolerable uncertainty and depressive symptoms, while positive coping strategies were negatively correlated with both intolerable uncertainty and depressive symptoms. Intolerable uncertainty was significantly and positively correlated with depressive symptoms. (2) Intolerance to uncertainty significantly predicted depressive symptoms. Both negative and positive coping strategies played parallel mediating roles in the relationship between unbearable uncertainty and depressive symptoms among college students. This study found that coping strategies played a mediating role in the relationship between unbearable uncertainty and depression during the pandemic in 2019. Future research and interventions should focus on enhancing tolerance of uncertainty and promoting positive coping strategies.

The mediating role of sleep quality in the relationship between orthorexia nervosa and fear of COVID-19

The COVID-19 (SARS-CoV-2) pandemic has jeopardized humanity worldwide and has considerably altered the healthy lifestyle behaviors of societies. This study examined the possible mediating role of sleep quality in the relationship between orthorexia nervosa and fear of COVID-19 among Turkish adults. This study used an observational and descriptive design. It was carried out online with 1,130 participants across Turkey between April and August 2021. The data were collected using a questionnaire, the Fear of COVID-19 Scale (FC-19S), the Pittsburgh Sleep Quality Index (PSQI), and Orthorexia Nervosa-R (ON-R). The participants had an ON-R mean score of 3.08 ± 0.90 and a mean PSQI score of 8.03 ± 2.80. Likewise, their mean FC-19S score was 18.24 ± 6.55. There was a significant positive correlation between the FC-19S and the PSQI (r = 0.208; p = 0.000) as well as a significant negative correlation between the ON-R and the PSQI (r = - 0.145; p = 0.000). In addition, the results of the process model analysis supported our hypotheses that the PSQI was a predictor of ON-R and that its direct and indirect effects were moderated by FC19S and the PSQI. A one-unit increase in FC-19S scores causes an average 1% increase on the ON-R scale, while it generates an 8% increase on the PSQI. It was determined that the PSQI total score caused an average of 6% increase in the ON-R scale score. The findings of this study showed that sleep quality has a mediating role in the relationship between orthorexia nervosa and fear of COVID-19 experienced by Turkish adults during the pandemic. For this reason, governments need to take the necessary precautions concerning this subject when creating action plans for possible global crisis situations that may adversely affect public health in the future.

Emotions, COVID-19 related thoughts and satisfaction with life during the critical period from control to relaxation

Introduction

In the context of declining mortality rates and increasing infectivity, it has become unavoidable for the majority of individuals to experience a COVID-19 infection at some point. This study aimed to investigate the psychological well-being of the general population during China's transition period from strict control measures to relaxed policies in COVID-19 prevention and control, as well as the impact of COVID-19 related thoughts on emotion and life satisfaction during widespread infections.

Methods

A cross-sectional study was conducted involving a sample size of 1578 participants. Participants completed self-report questionnaires assessing positive and negative emotions, thoughts about COVID-19, and satisfaction with life. Demographic characteristics such as sex, age, and education level were controlled for in the analysis.

Results

The findings revealed that individuals who had been infected with COVID-19 (specifically the Omicron variant BA.5.2 or BF.7) reported lower levels of positive emotions compared to those who were uninfected or had recovered from the infection. There was a significant relationship between COVID-19-related thoughts, emotions, and life satisfaction. Positive COVID-19 related thoughts were found to mediate the relationship between negative emotions and satisfaction with life.

Discussion

This study represents a comprehensive examination conducted in China, focusing on assessing the impact of the COVID-19 pandemic on the general population during the critical transition period from control to relaxation. Throughout this period, the number of infections experienced fluctuations, initially rising but eventually declining over a one-month span. In such a momentous historical period, maintaining a positive perspective on COVID-19 and its management becomes paramount in enhancing the emotional well-being, life satisfaction and overall well-being of individuals.

Unveiling the Path to Resilience: Prioritizing Mental Health, Sleep, and Nutrition in the Post-COVID Era

The COVID-19 pandemic has disrupted daily life, impacting relationships, work, and education. This has led to increased stress, anxiety, and depression, along with altered sleep patterns and eating behaviors. Quarantine and isolation have worsened mental health, especially in children and the elderly, due to the loss of activities and physical contact. Sleep disorders and negative dreams perpetuate poor sleep quality, increasing the risk of health issues. Sedentary lifestyles and emotional effects contribute to unhealthy eating patterns and obesity, exacerbated by disrupted routines and limited outdoor activities. Addressing these challenges requires prioritizing mental health, promoting healthy sleep habits, and addressing obesity factors. The pandemic has profoundly affected human well-being, but resilience, mental health, sleep, and nutrition can enhance overall well-being and adaptability in the post-COVID era. This comprehensive opinion aims to raise awareness of the wide-ranging impacts of this pandemic on various aspects of human well-being and to emphasize the importance of implementing strategies that prioritize mental health, improve sleep habits, address eating behaviors, and foster resilience to navigate and thrive in the face of future challenges.

The Impact of the First and Second Wave of the COVID-19 Pandemic on Eating Symptoms and Dysfunctional Eating Behaviours in the General Population: A Systematic Review and Meta-Analysis

BACKGROUND

The aim of this systematic review and meta-analysis was to examine the prevalence of feeding and eating disorder (FED) symptoms or dysfunctional eating behaviours (DEB) in the general population during the COVID-19 outbreak.

METHOD

We searched eligible articles in biomedical databases from 1 January 2020 to 31 March 2022. Prevalence rates of FED or DEB changes between pre-pandemic and pandemic time and correlation with psychological distress were pooled with a meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I2) statistics. A total of 186 studies with 406,076 participants met the inclusion criteria.

RESULTS

The more prevalent FED or DEB during the COVID-19 outbreak were: body image concerns (52%, 95% CI 0.38, 0.66), binge eating (40%, 95% CI 0.25, 0.55), and overeating (40%, 95% CI = 0.32-0.48). Pooled data of longitudinal studies (k = 8) only showed a significant difference in the prevalence of weight gain from pre-pandemic to the pandemic time. Finally, increased levels of psychological distress (k = 35) positively correlated with some ED symptoms.

CONCLUSION

This meta-analysis evidenced a negative impact of the pandemic on eating symptoms and DEB in the general population.

Mediation of self-concept clarity and self-control between negative emotional states and emotional eating in Chinese adolescents

Recent studies have consistently lent support for the significant relationship between negative emotional states (e.g., anxiety, stress, and depression) and emotional eating; however, only a handful of studies focused on examining the potential mediator in this association. The present study aimed to contribute to the literature surrounding the link between negative emotional states and emotional eating and to examine the mediating role of self-concept clarity and self-control in this association among a sample of Chinese adolescents (N = 1347, 62.44% girls). Results indicated that adolescents perceived higher levels of negative emotional states were linked to higher emotional eating. Additionally, the structural equation model suggested that symptoms of stress and depression could be associated with emotional eating through self-control. Moreover, the serial mediation effect of self-concept clarity and self-control could account for the association of negative emotional states (e.g., symptoms of anxiety, stress, and depression) and emotional eating. Overall, this study advances our understanding of the underlying mechanisms through which negative emotional states predict emotional eating in adolescence. If future studies reveal converging findings, this knowledge points to the need for programs preventing the development of emotional eating in adolescence through increasing the level of self-control and self-concept clarity.

Nutritional changes during the COVID-19 pandemic: a rapid scoping review on the impact of psychological factors

COVID-19 and the resulting measures to curb the spread of the virus have significantly changed our lives, including our nutritional choices. In this rapid scoping review an overview is provided of what psychological factors may be associated with peoples' eating behaviour during COVID-19 restrictions. Relevant literature was identified using PubMed, PsycInfo, CINAHL and MEDLINE databases from 2019 onwards. For included studies, information on study characteristics, eating behaviours, and psychological factors were extracted. 118 articles were included, representing 30 countries. Findings indicated that most people consumed more and unhealthy food in times of COVID-19 restrictions, while some consumed less but often for the wrong reasons. Several psychological factors, related to (1) affective reactions, (2) anxiety, fear and worriers, (3) stress and (4) subjective and mental wellbeing were found to be associated with this increase in food consumption. These outcomes may help to be better inform future interventions, and with that, to be better prepared in case of future lockdown scenarios.

Are depression, resilience and fear of COVID-19 related to eating behavior and nutrition status of university students?

OBJECTIVES

This study was designed to examine eating behaviors and their association with fear and depression states concerning COVID-19 among students in Turkey.

METHODS

A total number of 499 students, 336 (67.3%) female and 163 (32.7%) male, participated in an online-based cross-sectional study. The survey collected data on the Dutch eating behavior questionnaire (DEBQ), along with measuring psychological effect by using the Fear of COVID-19 Scale, Beck Depression Inventory, and Brief Resilience Scale. In addition, 24-h dietary records were used to calculate the daily energy and macronutrient intakes in the study.

RESULTS

A negative correlation between brief resilience and fear of COVID-19 was found. Total and subdomain DEBQ scores were positively correlated with fear of COVID-19; conversely, there was a negative correlation with brief resilience (P < 0.05). More than half (58.9%) of students had depression, and students who had moderate and severe depression had higher total DEBQ and emotional eating scores. Students with severe depression had the highest levels of fear of COVID-19. Students having higher daily energy intake had greater fear concerning COVID-19, and the daily energy intake was negatively correlated with restrained and external eating.

CONCLUSIONS

During the pandemic, negative psychological effects resulted in unfavorable dietary behavioral consequences, depending on the increasing levels of stress.

Does Fear of COVID-19 Prolongation Lead to Future Career Anxiety Among Adolescents? The Mediating Role of Depressive Symptoms

The outbreak of the COVID-19 pandemic has influenced the lives of individuals from all different age groups. In particular, the prolongation of COVID-19 and the emergence of virus variants, such as Omicron, Delta and Alpha, have caused trauma to university students amid expectations that the associated economic, social, and psychological outcomes could affect their future careers. The current study, therefore, examines how the fear of COVID-19 prolongation may affect future career anxiety (FCA) among adolescents and to what extent depressive symptoms may determine such a relationship. Using a cross-sectional design, a survey was conducted to assess depressive symptoms, FCA, and fear of COVID-19 prolongation among 605 university students in Oman, an Arabic-speaking country located in the Gulf region. Using structural equation modeling, the results showed that there were significant standardized direct effects (unmediated) of fear of COVID-19 on depression from COVID-19 and of depression from COVID-19 on FCA. Additionally, depression from COVID-19 mediated the relationship between fear of COVID-19 and FCA. The results are discussed within the Omani context of mental health service accessibility challenges and the dominant culture of perceiving mental health services with social stigma.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40653-022-00506-w.

Determining the relationship between anxiety levels, stress coping styles, and emotional eating of women in the COVID-19 pandemic

PURPOSE

This study aimed to determine the relationship between women's anxiety levels and their style of coping with stress and emotional eating in the COVID-19 pandemic.

METHODS

This is a cross-sectional study and data were collected using online surveys. The sample of the study consisted of 450 women between the ages of 18-65, who have no understanding and perception problems, and who are willing to participate in the study. The data were obtained using the "Introductory Information Form", "Coronavirus Anxiety Scale", "Stress Coping Styles Scale" and "Emotional Eating Scale". Descriptive statistics, Pearson correlation analysis and multiple regression analysis were used to analyze the data.

RESULTS

Increased emotional eating was increased helpless approach, submissive approach and Coronavirus anxiety increase while decreasing the self-confident approach. Increased Coronavirus anxiety was increased the total scores of helpless approach, submissive approach, disinhibition, guilt, and emotional eating increased while decreasing the scores of the self-confident approach and optimistic approach. BMI, weight change in pandemic, age, self-confident approach to coping with stress and helpless approach score explained emotional eating 30.8 %.

CONCLUSION

Considering the emotional eating score average (11-20), women were emotional eating, and their Coronavirus anxiety score was below the average. In minimizing emotional eating in women, first of all, emotional eating awareness should be created, and it is recommended to increase their awareness of stress coping styles for the stress that causes this situation.

Intolerance of uncertainty and future career anxiety among Chinese undergraduate students during COVID-19 period: Fear of COVID-19 and depression as mediators

Uncertainty is mushrooming throughout COVID-19, and intolerance of uncertainty (IoU) nudges people into mental health difficulties involving fear, depression, and anxiety. The objective of this study was to investigate the role of depression and fear of COVID-19 (FoC) in the association between IoU and future career anxiety (FCA) among Chinese university students during the COVID-19 pandemic. This study involved 1,919 Chinese undergraduate students from 11 universities in eight Chinese cities with an online self-administered survey that included demographic information, IoU, FoC, depression, and FCA completed by all participants. Our study demonstrated a positive relationship between IoU and FCA and the chain mediation effect of FoC and depression. Thus, understanding how FoC affects FCA not only informs university career professionals and assists students in preparing for employment, but also motivates schools to offer career opportunities workshops and, most importantly, provides mental health support to help students effectively cope with uncertainty and overcome COVID-19-related stress.

Measurement of burnout during the prolonged pandemic in the Chinese zero-COVID context: COVID-19 burnout views scale

Burnout is an important public health issue at times of the COVID-19 pandemic. Current measures which focus on work-based burnout have limitations in length and/or relevance. When stepping into the post-pandemic as a new Norm Era, the burnout scale for the general population is urgently needed to fill the gap. This study aimed to develop a COVID-19 Burnout Views Scale (COVID-19 BVS) to measure burnout views of the general public in a Chinese context and examine its psychometric properties. A multiphase approach including literature review, expert consultation, and pilot testing was adopted in developing the scale. The scale was administered to a sample of 1,078 of the general public in Hong Kong with an average age of 34.45 years (SD = 12.47). Exploratory and Confirmatory Factor Analyses suggested a 5-item unidimensional model of COVID-19 BVS. The CFA results indicated that the COVID-19 BVS had a good model fit, as χ2 (10.054)/5 = 2.01, SRMR = 0.010, CFI = 0.998, RMSEA = 0.031. Five items were maintained in EFA with high internal consistency in terms of Cronbach's α of 0.845 and McDonald's ω coefficient of 0.87, and the corrected item-to-total correlations of 0.512 to 0.789 are way above the acceptable range. The KMO values of 0.841 and Bartlett's Test of Sphericity (p < 0.01) verified the normal distribution of the EFA and the adequacy of the EFA sampling. The analyses suggest that the COVID-19 BVS is a promising tool for assessing burnout views on the impacts of the epidemic on the Chinese general populations.

Positive personality resources as buffers against psychological reactions to uncertainty

Since March 2020, Russia has been facing three lasting challenges of uncontrollable threat and uncertainty: the COVID-19 pandemic taking place at the global scale, and two national-level ones, the radical amendments to the Constitution and a drop in oil prices and national currency. We used this opportunity to investigate the way personality resources predict individual differences in the cognitive evaluations of uncertainty and emotional responses associated with each situation. We conducted a longitudinal study with 4 measurement waves between April and November 2020 in a sample of Russian-speaking volunteers (N = 219). The assessment of each of the three situations at each measurement occasion included the evaluation of its degree of certainty/uncertainty, general orientation, positive and negative emotions. We used repeated-measures ANOVA to explore the differences in cognitive appraisals and emotional reactions across time and situations, and multilevel modeling with random slopes to investigate the individual differences in the change trends for these variables. The results suggest that individuals with higher levels of personality resources tend to appraise the challenging situations as more certain, have a better sense of orientation in these situations, show more positive emotional responses, and exhibit more positive change trends over time reflecting successful adaptation.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12144-022-03879-1.

Nutritional behavior during the COVID-19 pandemic: the association of fear and sleep quality with emotional eating

PURPOSE

Even though it is known that fear and poor sleep quality trigger emotional eating, whether fear and poor sleep quality are associated with emotional eating during the COVID-19 pandemic is not clear. This study aimed to evaluate the association of fear of COVID-19, sleep quality, and some sociodemographic characteristics with emotional eating during the COVID-19 pandemic.

METHOD

This cross-sectional descriptive study was completed with 495 participants in Turkey. The participants filled out a questionnaire that asked about sociodemographic characteristics, fear of COVID-19, nutritional behaviors, sleep quality, and self-reported weight and height through email or social media.

RESULTS

The fear of COVID-19 score (β: 0.090, p < 0.05) and sleep quality score (β: 0.289, p < 0.001) were associated with the emotional eating score at the rate of 0.8% and 8.3%, respectively. The association of fear of COVID-19 with emotional eating disappeared when combined with various factors. The collective association of all factors, fear of COVID-19 (β: 0.042, p > 0.05), sleep quality (β: 0.246, p < 0.001), BMI (β: 0.275, p < 0.001), age (β:  - 0.259, p < 0.001) and gender (β:  - 0.169, p < 0.001) were associated with the emotional eating score at the rate of 18.3%.

CONCLUSIONS

These findings suggest that fear of COVID-19, sleep quality, BMI, age, and gender were associated with emotional eating during the pandemic. We hope that this study will help in the development of guidelines and strategies through understanding the factors associated with nutritional behavior during the pandemic period.

LEVEL OF EVIDENCE

Level V, cross-sectional descriptive study.

Relationship between Mental Health and Emotional Eating during the COVID-19 Pandemic: A Systematic Review

Obesity is one of the most dangerous epidemics of the 21st century. In 2019, the COVID-19 pandemic began and caused many deaths among patients with obesity with and without complications. Simultaneously, the lockdown related to the COVID-19 pandemic caused a host of emotional problems including anxiety, depression, and sleep disturbances. Many people began to cope with their emotions by increasing food (emotional eating) and alcohol consumption and in combination with decreased physical activity, promoted the development of overweight and obesity. Emotional eating, also known as stress eating, is defined as the propensity to eat in response to positive and negative emotions and not physical need. It should be noted that emotional eating may be the first step in the development of binge eating disorder and its extreme subtypes such as food addiction. Interestingly in some post-bariatric surgery patients, an increased frequency of addictive disorders has been observed, for example food addiction replaced by alcohol addiction called: “cross addiction” or “addiction transfer”. This data indicates that obesity should be treated as a psychosomatic disease, in the development of which external factors causing the formation of negative emotions may play a significant role. Currently, one of these factors is the COVID-19 pandemic. This manuscript discusses the relationships between the COVID-19 pandemic and development of emotional eating as well as potential implications of the viral pandemic on the obesity pandemic, and the need to change the approach to the treatment of obesity in the future.

Fear-Responses to Bat-Originating Coronavirus Pandemics with Respect to Quarantines Gauged in Relation to Postmodern Thought—Implications and Recommendations

Fear-responses to bat-originating coronavirus pandemics with respect to quarantine imposition are gathered and interpreted from large datasets, identified and disseminated by media. Responses are effectively gauged using postmodern thought with a continuum ranging from people’s resilience to define their own perspectives to public views being socially conditioned from media persistence in maintaining fear. Public responses to the 2003 SARS pandemic generally presumed and supported resilience of citizens’ perspectives. In contrast, from late 2019 to mid-2022, public responses to the COVID-19 pandemic were media-determined, promoting fear. In this regard, reactions to the COVID-19 quarantines are contrasted to the hospital isolations of SARS. The primary source of the difference was the major polarizing influence by social media of the WHO policy makers’ pronouncements and of healthcare providers’ statements directing media spotlight in their guidance of public response to COVID-19 throughout the pandemic, unlike during SARS. An investigation of cognitive bias regarding the psychological and societal implications related to this migration from resilience to fear regarding public responses to novel bat-originating coronavirus pandemics elicits recommendations concerning future quarantine dictates. These recommendations are dependent on appropriate encouragement of hopeful resilience through evidence based practice with respect to one extreme of the postmodern thought continuum.

Workplace Spirituality and Employee Wellbeing in the Hospitality Sector: Examining the Influence of Fear of COVID-19

Drawing from the job demands-resources theory and the protection motivation theory, this study attempts to examine how the experience of workplace spirituality impacts employee wellbeing during times of remote work. This study also examines how fear of COVID-19 moderates the aforementioned relationship. Using a self-administered questionnaire, data were collected from 566 employees working in the hospitality sector in India. Results revealed that the experience of three dimensions of workplace spirituality (meaningful work, sense of community, and alignment with organisational values) had a significant positive influence on employee wellbeing, even during remote work. Fear of COVID-19 had an interesting significant moderating effect, and it was revealed that the higher the fear, the stronger the relationship between the workplace spirituality (in terms of meaningful work, sense of community, and alignment with organisational values) and employee wellbeing. The insights gained from this study will assist both the employees and the managers in devising personalised approaches towards individual wellbeing and the organisation at large during times of pandemics.

Relationship between COVID-19 anxiety and fear of death: the mediating role of intolerance of uncertainty among a Turkish sample

The Coronavirus Disease 2019 (COVID-19) pandemic has increased the salience of death in our lives. The aim of this study is to uncover potential mechanisms underlying fear of death during the pandemic. A sample of 478 volunteers (312 females and 166 males) aged 18 years and older participated voluntarily in this study. Coronavirus Anxiety Scale, Multidimensional Mortality Awareness Measure, Intolerance of Uncertainty Scale, and Personal Information Form were used for data collection. The mediating role of intolerance of uncertainty in the relationship between COVID-19 anxiety and fear of death was determined using the bootstrapping method. COVID-19 anxiety was associated with increased intolerance of uncertainty, and fear of death. Intolerance of uncertainty was associated with increased fear of death. Furthermore, intolerance of uncertainty partially mediated the relationship between COVID-19 anxiety and fear of death. Results suggest that intolerance of uncertainty is a critical variable in the relationship between COVID-19 anxiety and fear of death. The current research adds to our knowledge of fear of death by investigating COVID-19 anxiety and intolerance of uncertainty. Additionally, this study underlies and contributes to the consideration of psychological health of individuals during the pandemic process. The results are discussed within the context of the COVID-19 pandemic.

Intolerance of Uncertainty and Risk Perception during the COVID-19 Pandemic: The Mediating Role of Fear of COVID-19

The COVID-19 pandemic, a period of uncertainty and risk, has presented a threat to people’s physical and mental health worldwide. Previous research has shown that pandemic-related uncertainty can contribute to individuals’ psychological distress and coping responses. Therefore, the aim of this study was to investigate the relationship between intolerance of uncertainty and risk perception (i.e., individual’s perceived likelihood of becoming infected both for themselves and people in one’s own country and perceived severity of the infection), and the mediating role of fear of COVID-19. This two-wave longitudinal study (T1 = April 2020; T2 = May 2020) involved 486 young adults (age range = 18–29 years; Mage = 23.84 ± 2.94). Participants provided demographic data as well as measures of intolerance of uncertainty, fear of COVID-19, and risk perception. Structural equation modeling showed that intolerance of uncertainty was indirectly related to risk perception through fear of COVID-19. The study confirms the central role of IU in fear management and, consequently, in determining individuals’ risk estimates.

Relationships between fear of COVID ‐19, cyberchondria, intolerance of uncertainty, and obsessional probabilistic inferences: A structural equation model

The study was set out to explore the structural relationships between fear of COVID‐19, cyberchondria, intolerance of uncertainty, and obsessional probabilistic inferences. The data were recruited online from a community population (n = 1,049) subjected to a confirmatory factor analytic procedure. The structural model specified according to the previous findings in the literature showed that a general tendency to negative expectations in terms of probabilistic thinking was significantly associated with both COVID‐19‐related‐fear and intolerance of uncertainty. Fear of COVID‐19 was significantly associated with cyberchondria. Probabilistic thinking style and intolerance of uncertainty contributed to cyberchondria through fear of COVID‐19 as well. We concluded that a tendency to engage in a probabilistic thinking style and intolerance of uncertainty seems to play role in the etiology of fear of infection and cyberchondria.

Intolerance of COVID-19-related uncertainty and depressive and anxiety symptoms during the pandemic: A longitudinal study in Argentina

The current COVID-19 pandemic is a novel, unprecedented situation that has created considerable uncertainty due in part to the unpredictability of the future situation. Intolerance of Uncertainty is the inability to withstand negative uncertain situations, and predisposes people to overestimate threats and to develop psychopathological symptoms. The aim of this study was to longitudinally analyze the relationship between intolerance of COVID-19-related uncertainty and anxiety and depression symptoms. A non-probabilistic online snowball sampling method was used. For the study, 1230 Argentine adults (216 men; 1005 women; 9 other genders; mean age = 41.62; SD = 13.81) were recruited to complete three open-access surveys at three different time points: (1) between May 6 and June 1, 2020, (2) between August 8 and 13, 2020, and (3) between April 17 and 23, 2021. The results suggest that anxiety and depressive symptoms increase over time, and that intolerance of uncertainty is a predictor of this variability even up to eleven months after the initial assessment. Gender- and age- related effects were also observed (women and young people reported more psychopathological symptoms). The findings suggest the importance of intolerance of uncertainty for mental health and the importance of this type of study for understanding the psychological impact of the pandemic.

Can “Free-From” Food Consumption Be a Signal of Psychological Distress during COVID-19?

During the last year, feelings of anxiety and depression were registered among the Italian population and affected food consumption. Among the research that explored people’s dietary inclinations during the current pandemic, no previous studies have explored psychological factors associated with the “free-from” dietary pattern. Our study is aimed at understanding if free-from food consumption orientations can be associated with negative psychological distress. We conducted a web-based survey between 27/10/2020–03/12/2020 on a representative sample of 963 Italians. Psychometric scales and ad hoc items were used to measure people’s levels of anxiety, depression, fear for contagion and consumption orientation towards “free-from” foods. Of the sample, 18.2% frequently purchased gluten-free food products and 22.5% purchased lactose-free foods. Most of the population (44.1%) feels very at risk of contagion from COVID-19 and suffers from anxiety (52.8%) and depression (55.0%). Free-from consumers are more anxious, depressed, have higher risk of contagion, and are younger than the non-consumers. During the COVID-19 pandemic, free-from foods can represent for the people a way to restore control over their lifestyle, which was denied during the emergency. However, we highlight possible negative long-term effects of this dietary choice.

Anxiety, Anhedonia, and related food consumption at the beginning of the COVID-19 quarantine in populations of Spanish-speaking Ibero-American countries: An online cross-sectional survey study

•In Ibero-American, the anxiety and anhedonia are related to the consumption of food. •The anxiety is related to the consumption of palatable foods during confinement. •The different type of foods had a different probability of increasing serving size. •An increase in average body weight was observed during confinement for COVID-19.

The Effect of Fear of the COVID-19 on Depression Among Chinese Outbound Students Studying Online in China Amid the COVID-19 Pandemic Period: The Role of Resilience and Social Support

Objective: The present study focused on examining fear of the coronavirus disease 2019 (COVID-19) is correlated with depression and explored the potential role of resilience and social support on the association between fear of the COVID-19 (FoC) and depression among Chinese outbound students studying online in China amid the COVID-19 pandemic period. Methods: A total of 476 Chinese outbound students from different universities worldwide, currently studying via online mode in China, completed an online survey including measures on FoC, resilience, social support, and depression. Results: (1) Fear of the COVID-19 was positively correlated with depression and negatively correlated with resilience and social support. Both resilience and social support were negatively correlated with depression. Social support showed a positive correlation with resilience. (2) The effect of FoC on depression mainly occurred through two paths: the mediating effect of resilience and the moderating effect of resilience. However, the moderating effect of social support on the association between FoC and depression was not sustained in this study. Conclusion: This study indicated the mediating and moderating effects of resilience on the association between FoC and depression among Chinese outbound students studying online in China during the COVID-19 pandemic period. The current findings confirmed that resilience has significant implications in preventing negative mental states under the COVID-19 context among this particular group.

Trends in Food Preferences and Sustainable Behavior during the COVID-19 Lockdown: Evidence from Spanish Consumers

The COVID-19 pandemic poses a threat to global food security, and it changes consumers' food buying and consumption behavior. This research not only investigates trends in Spanish consumers' general food shopping and consumption habits during the lockdown, but also investigates these trends from the perspective of sustainable purchasing. Specifically, total food consumption (C), food expenditure (E), and purchase of food with sustainable attributes (S) were measured. Data were collected from a semi-structured questionnaire which was distributed online among 1203 participants. The logit models showed that gender, age, employment status, and consumers' experiences were associated with total food consumption and expenditure during the lockdown. In addition, consumers' risk perceptions, shopping places, trust level in information sources, and risk preference were highly essential factors influencing consumers' preferences and sustainable behavior. Consumers' objective knowledge regarding COVID-19 was related to expenditure. Furthermore, family structure only affected expenditure, while income and place of residence influenced food consumption. Mood was associated with expenditure and the purchase of sustainable food. Household size affected purchasing behavior towards food with sustainable attributes. This research provides references for stakeholders that help them to adapt to the new COVID-19 situation.

Exploring the Interrelationship between COVID-19 Phobia, Work–Family Conflict, Family–Work Conflict, and Life Satisfaction among School Administrators for Advancing Sustainable Management

This study aims to investigate the relationships between the COVID-19 phobia experienced by school administrators and their work–family conflict, family–work conflict, and life satisfaction. This descriptive research, designed according to the relational survey model, was conducted with the participation of 356 school administrators. The study data were collected through online questionnaires, and then t-test, ANOVA, correlation analysis, and simple linear regression analysis were employed for the statistical analyses. The results revealed that female school administrators experienced greater levels of COVID-19 phobia than their male peers and that COVID-19 phobia is felt more intensely in the psychological and social sub-dimensions. However, female school administrators’ life satisfaction levels were significantly higher than those of male school administrators. In the current study, it was determined that school administrators in the younger age group experienced greater levels of COVID-19 phobia and family–work/work–family conflict than their peers from other age groups. The results of this study revealed a positive and moderate relationship between school administrators’ COVID-19 phobia and their levels of both work–family and family–work conflict. The findings of the study offer significant implications for policy makers in education, showing the importance of developing strategies that will reduce the effects of the pandemic for a more sustainable and efficient employee performance.

Accepting Restrictions and Compliance With Recommended Preventive Behaviors for COVID-19: A Discussion Based on the Key Approaches and Current Research on Fear Appeals

COVID-19 (Coronavirus disease 2019) is a novel coronavirus which was first detected in late December 2019 in the Wuhan Province of China. This novel coronavirus, caused by a zoonotic beta-coronavirus (SARS-CoV-), is described as highly infectious. The World Health Organization (WHO) named the novel coronavirus as COVID-19 on February 11, 2020, and declared it as a "pandemic." Almost all countries have undertaken wide-scale precautions so as to prevent or limit the spread of the virus, with most having practiced some form of "lockdown" along with "social distancing," as well as dispensed recommendations for proper hand washing, avoiding touching the face, wearing facemasks, and using disposable tissues when either coughing or sneezing. Whereas it is well known that slowing the spread of this new epidemic requires the cooperation of all citizens, some people still seem to willfully disregard the rules and guidelines, and thereby ignore the health risks posed to both themselves and to others they come into contact with. People have responded differently to lockdown rules and social distancing practices. Whilst the majority follow the rules and recommendations with great care, others are more lax or simply refuse to comply. These differences might be accounted for according to a number of factors including personal, social, cultural, mental, and economic variables. Being persuaded to comply with preventive rules, especially those concerned with health-related behaviors, also bring certain other factors into play. Fear is one of those factors, and is one of the most powerful. It is well known that fear-based appeals can be effective in inculcating health behaviors, with many theories having been developed in this area. However, both the content of the message (the level of the fear it contains) and certain personal variables can determine the persuasive power of the fear appeal. It can even have an adverse effect if not properly applied. Many theories have been developed to address the persuasive effectiveness of the fear appeal (e.g., fear-drive theory, protection-motivation theory), and this study aims to discuss these individual differences in precautionary and preventive measures for the COVID-19 pandemic within the framework of the basic assumptions of these theoretical approaches.

The Perceived Impact of COVID-19 on Comfort Food Consumption over Time: The Mediational Role of Emotional Distress

The COVID-19 pandemic has had a significant impact on populations at an economic, health, and on an interpersonal level, it is still unclear how it has affected health-risk behaviors, such as comfort food consumption over time. This study longitudinally examines the effect of the perceived impact of COVID-19 on comfort food consumption and whether this effect is mediated by emotional distress. A convenience sample of 1048 students and university staff (academic and non-academic) from two universities completed monthly online surveys during the COVID-19 pandemic across six waves (W; W1 to W6). Participants reported their perceived impact of COVID-19 (economic, interpersonal, and health), comfort food consumption, and emotional distress (DASS-21). Using structural equation models, we found an indirect longitudinal effect of the perceived impact of COVID-19 (W1) on comfort food consumption (W3 to W6) through increased emotional distress (W2). The perceived negative impact of COVID-19 on comfort food consumption was fully mediated by the emotional distress during the first waves (W3 and W4), ending in a partial mediation in the last waves (W5 and W6). These findings contribute to disentangling the mechanisms by which the perceived impact of COVID-19 affects comfort food consumption over time, and highlight the role of emotional distress. Future interventions should address comfort food consumption by focusing on handling emotional distress during a crisis.

Pregnancy Outcome during the First COVID 19 Lockdown in Vienna, Austria

The COVID 19 pandemic represents a major stress factor for non-infected pregnant women. Although maternal stress during pregnancy increases the risk of preterm birth and intrauterine growth restriction, an increasing number of studies yielded no negative effects of COVID 19 lockdowns on pregnancy outcome. The present study focused on pregnancy outcome during the first COVID 19 lockdown phase in Austria. In particular, it was hypothesized that the national lockdown had no negative effects on birth weight, low birth weight rate and preterm birth rate. In a retrospective medical record-based single center study, the outcome of 669 singleton live births in Vienna Austria during the lockdown phase between March and July 2020 was compared with the pregnancy outcome of 277 live births at the same hospital during the pre-lockdown months of January and February 2020 and, in addition, with the outcome of 28,807 live births between 2005 and 2019. The rate of very low gestational age was significantly lower during the lockdown phase than during the pre-lockdown phase. The rate of low gestational age, however, was slightly higher during the lockdown phase. Mean birth weight was significantly higher during the lockdown phase; the rates of low birth weight, very low birth weight and extremely low birth weight were significantly lower during the lockdown phase. In contrast, maternal gestational weight gain was significantly higher during the lockdown phase. The stressful lockdown phase in Austria seems to have no negative affect on gestational length and newborn weight among non-infected mothers.

Intolerance of uncertainty, rumination, post-traumatic stress symptoms and aggression during COVID-19: a serial mediation model

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic can be identified as a source of traumatic stress. Previous studies have shown that post-traumatic stress and intolerance of uncertainty are associated with aggressive behaviour.

OBJECTIVE

In the present study, we aimed to test a serial mediation model, considering rumination and post-traumatic stress symptoms (PTSS) as mediators that link intolerance of uncertainty and aggression, while controlling the confounding effect of crisis-induced health and socioeconomic stressors during the COVID-19 pandemic.

METHOD

A total of 714 participants [533 (74.6%) females, 176 (24.7%) males, aged 18-64 years (M _age = 25.16, SD _age = 9.34)] completed the following self-reported scales: Aggression Scale, COVID-19 stressors checklist, Short Version of the Intolerance of Uncertainty Scale, Impact of Event Scale with Modifications for COVID-19, and Ruminative Thought Style Questionnaire.

RESULTS

The results revealed that there was an association between intolerance of uncertainty and aggressive behaviours. Moreover, the results of serial mediation analysis showed that intolerance of uncertainty predicts aggressive behaviours via rumination and PTSS. Besides, socioeconomic stressors are significantly associated with the level of PTSS and aggression, while health stressors are not significantly association with the level of PTSS and aggression.

CONCLUSIONS

The findings provide several contributions to understand the link between intolerance of uncertainty and aggressive behaviours during the COVID-19 pandemic, and confirm the importance of early psychological intervention, especially for those who are more likely to ruminate and suffer from PTSS, to prevent aggression and violence in the long run. In addition to health-related regulations, it is important to take the social and economic aspects of the crisis into account and develop intervention strategies accordingly. Nevertheless, the limitations of cross-sectional mediation analysis in explaining causal relationships should be kept in mind, and future studies should extend these findings using longitudinal data.