Assessing the Geographic Context of Risk Perception and Behavioral Response to Potential Ebola Exposure

Psychological distress of college students during the COVID-19 pandemic

Objectives To assess levels of psychological distress among a group of US undergraduate college students during the initial phases of the novel coronavirus (SARS-CoV-2) pandemic. Methods: All undergraduates at Kent State University were surveyed in three randomly selected cohorts on March 18, March 25, and April 1, yielding 3924 valid responses for the weighted dataset (73.8% female, 88.9% White). Distress was assessed using the Kessler Psychological Distress Scale (K6). Data were weighted using known population counts. Results: K6 scores averaged 8.19 ± 5.9, with 44.3% in the moderately elevated range and 23.8% above the cutoff for severe psychological distress.Conclusions: A high proportion of undergraduate university students reported elevated psychological distress as the COVID-19 pandemic unfolded. K6 scores appeared higher than averages from comparison samples. Targeted surveillance can inform public health in mitigating threats to mental health conferred by pandemics. Colleges and universities should anticipate sharply elevated psychological distress during and after the COVID-19 pandemic.

Panic, Psycho-Behavioral Responses, and Risk Perception in the Earliest Stage of the COVID-19 Pandemic in China

Background

Coronavirus Disease-19 (COVID-19), a rising global pandemic, has triggered psychological crises among the public. Panic, a severe symptom of mental disorders, is increasing in the public in China and it is urgent to provide research for intervention development.

Objectives

This study aimed to assess the prevalence of public panic in China during the earliest stage of the COVID-19 pandemic and to explore the associated psychological behavioral responses and public's risk perception of the pandemic.

Methods

A cross-sectional study using a web-based survey with convenience sampling was conducted with 2,484 participants nationally from February 11 to February 24, 2020 in China. A self-developed questionnaire was applied to assess the prevalence of public panic and its associated factors. Multivariable logistic regression analysis was applied to assess the risk and protective factors of public panic.

Results

There were 23.39% (581/2,484) of the participants who reported experiencing panic during the earliest stage of the COVID-19 pandemic. Taking temperature repeatedly, being nervous in a crowd, being suspicious of infection in the family, being worried about the future, and worries about high infectivity of the COVID-19, lack of effective therapies, and wide impact of the COVID-19 pandemic increased the odds of public panic. Whereas, avoiding gatherings during holidays was negatively associated with the odds of public panic.

Conclusions

Psycho-behavioral responses were closely associated with public panic during the earliest stage of the COVID-19 pandemic in China. Defusing excessive health-related worries, the guidance of appropriate self-protective behaviors, strengthening of health education in communities, and available treatment for mental disorders should be adopted to monitor the psychological responses and to guide the behaviors of the public.

Distress and Prevention Behaviors During the COVID-19 Pandemic Among College Students: the Moderating Role of Resilience

Background

Pandemics can generate considerable distress, which can affect prevention behaviors. Resilience may buffer the negative effects of distress on engagement in relevant prevention behaviors, which may also hold true for COVID-19 prevention behaviors. The objective of the current study was to evaluate whether resilience moderated the relationship between distress and COVID-19 prevention behaviors early in the pandemic.

Methods

Data were collected via surveys in which all students at a large midwestern university were emailed invitations beginning March 18, 2020. Surveys were completed by 5,530 individuals. In addition to demographic questions and items about COVID-19 prevention behaviors, distress was assessed using the K6 Distress Scale and resilience using the Brief Resilience Scale. Data were analyzed using moderator regression analysis.

Results

Resilience moderates the effects from distress to prevention behaviors, such that the relationship was stronger for individuals with higher resilience than for individuals with lower resilience. When resilience was one standard deviation below the mean, at the mean value of resilience, and when resilience was one standard deviation above the mean, there was a significant positive relationship between distress and COVID-19 prevention behaviors. However, the relationship was strongest for those with high resilience, and lowest for those with low resilience.

Conclusions

In the current sample, resilience appeared to influence the strength of the relationship between distress and COVID-19 prevention behaviors. Having higher resilience may promote positive adaptation to distress, leading individuals to engage in a greater number of disease-related prevention behaviors. Future research should examine this relationship longitudinally and in relation to differing constructs of resilience.

Who Is the Most Vulnerable to Anxiety at the Beginning of the COVID-19 Outbreak in China? A Cross-Sectional Nationwide Survey

(1) Background: The COVID-19 pandemic has not only changed people’s health behavior, but also induced a psychological reaction among the public. Research data is needed to develop scientific evidence-driven strategies to reduce adverse mental health effects. The aims of this study are to evaluate the anxiety reaction of Chinese people and the related determinants during the earliest phase of the COVID-19 outbreak in China. Evidence from this survey will contribute to a targeted reference on how to deliver psychological counseling service in the face of outbreaks. (2) Methods: A cross-sectional, population-based online survey was conducted from 28 January to 5 February 2020 using an open online questionnaire for people aged 18 years or above, residing in China and abroad. The socio-demographic information of the respondents was collected, and anxiety scores were calculated. A direct standardization method was used to standardize anxiety scores and a general linear model was used to identify associations between some factors (e.g., sex, age, education, etc.) and anxiety scores. (3) Results: A total of 10,946 eligible participants were recruited in this study, with a completion rate of 98.16% (10,946/11,151). The average anxiety score was 6.46 ± 4.12 (total score = 15); women (6.86 ± 4.11) scored higher than men (5.67 ± 4.04). The age variable was inversely and significantly associated with the anxiety score (β = −2.12, 95% CI: −2.47–−1.78). People possessing higher education (β = 1.15, 95% CI: 0.88–1.41) or a higher awareness of cognitive risk (β = 4.89, 95% CI: 4.33–5.46) reported higher levels of anxiety. There was a close association between poor subjective health and anxiety status (β = 2.83, 95% CI: 2.58–3.09). With the increase of confidence, the anxiety of the population exhibited a gradual decline (β = −2.45, 95% CI: −2.77–−2.13). (4) Conclusion: Most people were vulnerable to anxiety during the earliest phase of the COVID-19 outbreak in China. Younger women, individuals with high education, people with high cognitive risk and subjective poor health were vulnerable to anxiety during the epidemic. In addition, increasing confidence in resisting this pandemic is a protective determinant for individuals to develop anxiety. The findings suggest that policymakers adopt psychosocial interventions to reduce anxiety during the pandemic.

What Prompts Doctors to Recommend COVID-19 Vaccines: Is It a Question of Positive Emotion?

Vaccines are among the most successful and cost-effective public health tools and have greatly contributed to eliminating or controlling several serious vaccine-treatable diseases over the past century. To curb the spread of COVID-19, efficacious vaccination is emerging as essential in mitigating the disease and preventing deaths. Health care workers (HCW) are one of the first groups to receive vaccinations, so it is important to consider their attitudes to COVID-19 vaccination to better address barriers to widespread vaccination acceptance. This study aimed to evaluate variables that are linked with the recommendation of vaccines and intention to take-up vaccination against COVID-19 among the HCWs, in the context of the current pandemic. The study was conducted during the first week of the vaccination campaign dedicated to Italian HCWs, beginning in December 2020, and it involved all doctors in a public hospital in Sicily. The following questionnaires were administered: (1) The perceived vaccine trust questionnaire, measuring the degree of trust in vaccines by healthcare professionals both in general and for the protection of healthcare professionals themselves and patients; (2) the positive and negative affect scale-state (PANAS), for assessing positive and negative emotions in relation to their work as “frontline care providers”; (3) The locus of control of behaviour (LCB) to measure the extent to which subjects perceive responsibility for their personal behaviour (internal vs. external); (4) recommendation vaccines item, referring to the intention to recommend vaccination. The findings suggest that socio-demographic control variables (age, gender, and seniority) showed little or no predictive power in vaccine recommendation, while vaccine confidence, positive emotions, and internal locus of control were excellent predictors of vaccine recommendations by doctors. Younger doctors, both in age and experience, are more confident in vaccines and recommend them more frequently. It is essential to improve institutional communication addressed to doctors to enhance their role as vaccination facilitators.

Rethinking the Role of Affect in Risk Judgment: What We Have Learned From COVID-19 During the First Week of Quarantine in Italy

Due to COVID-19 spreading in Italy, on March 11 the Prime Minister of Italy declared a lockdown and imposed severe restrictive measures impacting citizens’ freedom at several levels. People were required to stay at home and go out only to satisfy basic needs. Several risk models have postulated a link among online searching behavior, affect, anxiety, and complaints by individuals toward government restrictions (GR), which emerged as also related to an increased perception of knowledge toward risk. However, to date, no study has addressed how these key risk-related aspects (i.e., affect, anxiety, perceived knowledge on risk, and risk dimensions) can act jointly to orient online health information-seeking behavior, and people’s complaints toward GR imposed during the lockdown. This study investigated the mechanisms underlying online health information-seeking behavior and people’s complaints toward the government’s restrictions during a COVID-19 emergency in the Italian population. Drawing from the health belief model (HBM), which postulates a link between sociodemographic variables, risk, and affect dimensions in emergency, we assumed risk factors as predictors of affect and anxiety, which, in turn, were posited as mediators between risk dimensions, online health information-seeking behavior, and complaints toward GR. Participants (1,031) were involved during the first week of the quarantine (March 11–18) and completed an online survey composed of (i) an adapted version of the Italian Risk Perception Questionnaire; (ii) the Italian Positive (PA) and Negative Affect (NA) Schedule (PANAS-10); (iii) the State Anxiety Scale (STAI-Y1); (iv) ad hoc personal knowledge measure about novel coronavirus; (v) ad hoc item measuring information search behavior regarding the novel coronavirus; (vi) ad hoc measure of the complains regarding GR; and (vii) sociodemographic questions. General linear models and structural equation modeling (SEM) were carried out to test the model. Sociodemographic and cognitive factors predicted the participants’ affect and anxiety, which, in turn, motivated and fully mediated both information search behavior and complaint toward GR. This research can offer useful suggestions for policy-makers during the COVID-19 emergency, and it advanced the knowledge on the risk–emotion link in emergency situations.