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Stone BM, Wang V. Emotional fear of COVID-19, but not physiological expressions of fear, explains variability in COVID-19's impact on individuals' lives. J Affect Disord Rep 2023; 11:100479. [PMID: 36624855 PMCID: PMC9814283 DOI: 10.1016/j.jadr.2023.100479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/03/2023] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
The COVID-19 pandemic has had a profound and robust impact on individuals' lives and has particularly negatively affected individuals' experiences with fear of catching COVID-19. To measure this fear, researchers created the unidimensional Fear of COVID-19 Scale (FCV-19S). However, some exploratory factor analysis studies suggested the presence of two factors, which are 1) emotional fear and 2) physiological expressions of fear. In the current exploratory study, we aimed to confirm this factor structure using confirmatory factor analysis and to examine how these two new factors of the FCV-19S explain variability in the impacts of COVID-19 on nine life domains (i.e., finances, loved ones, job, safety, school, mental health, physical health, social activities, and quality of life). Participants were undergraduate students (n = 224) from a Midwestern University (White: 60.7%; Male: 48.0%) who participated in the study for course credit. The results revealed that the two-factor model had an excellent fit for the FCV-19S, both subscales had excellent psychometric properties, and the emotional fear subscale significantly explained variability in all nine life domains (7% to 54%). However, the physiological fear subscale only significantly explained variability in the physical health domain along with emotional fear (28%). The findings suggested that emotional fear of COVID-19 may explain more variability in the impact of COVID-19 across life domains, while physiological fear may only explain the effects of COVID-19 on physical health. We further discussed implications, limitations, and future directions.
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Key Words
- CFA, confirmatory factor analysis
- CFI, Comparative Fit Index
- CIDS, Coronavirus Impact Domains Scale
- COVID-19
- COVID-19 impact
- COVID-19, coronavirus disease 2019
- EFA, exploratory factor analysis
- FCV-19S
- FCV-19S, Fear of COVID-19 Scale
- Factor analysis
- Fear of COVID-19
- Fear of COVID-19 Scale
- M, Mean
- RMSEA, Root Mean Square Error of Approximation
- SD, standard deviation
- SE, standard error
- SRMR, Standardized Root Mean Squared Residual
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Affiliation(s)
- Bryant M. Stone
- College of Medicine, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President Street, Charleston, SC 29425, USA,School of Psychological & Behavioral Sciences, Department of Psychology, Southern Illinois University, 1125 Lincoln Drive, Carbondale, IL 62901, USA,Corresponding author
| | - Vanessa Wang
- School of Psychological & Behavioral Sciences, Department of Psychology, Southern Illinois University, 1125 Lincoln Drive, Carbondale, IL 62901, USA
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Daniels A, Wellan SA, Walter H. Learning it the hard way - how enjoying life and positive appraisal buffer the negative effects of stressors on mental health in the COVID-19 pandemic. J Affect Disord Rep 2021; 6:100200. [PMID: 34957432 PMCID: PMC8684292 DOI: 10.1016/j.jadr.2021.100200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 06/25/2021] [Accepted: 07/18/2021] [Indexed: 12/05/2022] Open
Abstract
Background Higher levels of stress and negative emotions such as anxiety and depression have been reported since the beginning of the COVID-19 pandemic, but it remains less clear how positive emotions, such as hedonic capacity, may be affected. Further, during lockdowns, the ability to learn new pleasurable activities (hedonic learning) may be particularly relevant. Here, we investigated if state hedonia and/or hedonic learning mediated the relationship between COVID-19 stress and mental health. Moreover, we explored whether positive appraisal style (PAS), a major resilience factor, influenced these relationships. Methods Using a cross-sectional design, 5000 German-speaking participants filled out online questionnaires targeting stressors, mental health, state hedonia, hedonic learning, and PAS between April 9 and May 15, 2020. After confirming the factor structure of our constructs, we applied latent structural equation modeling to test mediation as well as moderated mediation models. Results Stress showed a positive association with mental health symptoms, which was buffered by both state hedonia and hedonic learning. While higher stress was related to lower state hedonia, participants reported more hedonic learning with greater stressor load. The latter effect was greater for individuals with high PAS. Limitations The present results should be replicated in longitudinal designs with representative samples to confirm the directionality and generalizability of effects. Conclusions Both state hedonia and hedonic learning buffered the effect of stress on mental health in an early phase of the COVID-19 pandemic. Learning new rewarding activities in combination with a PAS may be especially relevant for maintaining mental health during lockdowns.
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Key Words
- ACIPS, Anticipatory and Consummatory Interpersonal Pleasure Scale
- AIC, Akaike Information Criterion
- Anhedonia
- BIC, Bayesian Information Criterion
- CFA, confirmatory factor analysis
- CFI, comparative fit index
- CI, confidence interval
- COVID-19
- COVID-19, coronavirus disease 2019
- DARS, Dimensional Anhedonia Rating Scale
- EFA, exploratory factor analysis
- GHQ-12, 12-item General Health Questionnaire
- MLR, robust maximum likelihood
- Mental health
- PAS, positive appraisal style
- Positive appraisal
- RMSEA, root mean square error of approximation
- Reward learning
- SARS-CoV-2, severe acute respiratory syndrome coronavirus 2
- SEM, structural equation modeling
- SRMR, standardized root mean square residual
- Stress
- TEPS, Temporal Experience of Pleasure Scale
- TLI, Tucker Lewis index
- aBIC, sample-size adjusted BIC
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Affiliation(s)
- Anna Daniels
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charitéplatz 1, 10117 Berlin, Germany.,Humboldt-Universität zu Berlin, Faculty of Philosophy, Berlin School of Mind and Brain, Berlin, Germany
| | - Sarah A Wellan
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charitéplatz 1, 10117 Berlin, Germany.,Humboldt-Universität zu Berlin, Faculty of Philosophy, Berlin School of Mind and Brain, Berlin, Germany
| | - Henrik Walter
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Neurosciences CCM, Research Division of Mind and Brain, Charitéplatz 1, 10117 Berlin, Germany.,Humboldt-Universität zu Berlin, Faculty of Philosophy, Berlin School of Mind and Brain, Berlin, Germany
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Abdullah B, Kandiah R, Hassan NFHN, Ismail AF, Mohammad ZW, Wang DY. Assessment of perception, attitude, and practice of primary care practitioners towards allergic rhinitis practice guidelines: Development and validation of a new questionnaire. World Allergy Organ J 2020; 13:100482. [PMID: 33294114 PMCID: PMC7689322 DOI: 10.1016/j.waojou.2020.100482] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 10/06/2020] [Accepted: 10/21/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Primary care practitioners (PCPs), being the front liners, play an important role in treating allergic rhinitis (AR). As there is no proper tool to assess their perception, attitude, and practice in utilizing the guidelines, we aimed to develop and validate a new questionnaire for such purpose. METHODS The development phase consists of both literature and expert panel review. The validation phase consists of content validity, face validity, and construct validity. Cronbach's alpha was used to verify internal consistency. The development phase produced a questionnaire with 3 domains: perception, attitude, and practice consisting of 60 items (PAP-PCP questionnaire). Item response theory analysis for perception demonstrated the difficulty and discrimination values were acceptable except for 3 items. Exploratory factor analysis for attitude and practice domains showed the psychometric properties were good except for 3 items in practice domain. Experts judgement was used to decide on the final selection of questionnaire which consists of 59 items. RESULTS The final validated questionnaire has 3 domains with 59 items. All domains had Cronbach's alpha above 0.65 which was reliable. 302 physicians completed the questionnaire. 98% PCPs diagnosed AR based on clinical history. Although, majority agree AR guidelines is useful (67%), they had difficulty in using it to classify AR (54.9%) and determine AR severity (73.9%). Oral anti-histamines (first and second generation) were the most prescribed (>75%) followed by intranasal corticosteroids (59%) and combined intranasal corticosteroid and oral anti-histamine (51%). Majority agreed that treatment efficacy (81.8%), adverse effects (83.8%), fear of adverse effects (73.5%), route of administration (69.4%), dosing frequency (72.5%), taste (64.6%) and cost (73.5%) affect treatment compliance. CONCLUSIONS The newly developed and validated questionnaire is a promising instrument in understanding the treatment gap in AR. Although further testing and refinement are needed, it provides an initial means for evaluating knowledge and understanding of PCPs in treating AR.
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Key Words
- 2-PL IRT, Two-parameter logistic item response theory
- ARIA, Allergic Rhinitis and its Impact on Asthma
- Allergic rhinitis guidelines
- Attitude
- CVI, Content Validity Index
- EAR, Allergic rhinitis
- EFA, exploratory factor analysis
- FVI, Face Validity Index
- GINA, Global Initiative for Asthma
- IgE, immunoglobulin
- KMO, Kaiser-Meyer-Olkin test
- ORL, Otorhinolaryngologist
- PCPs, Primary care practitioners
- Perception
- Practice
- Primary care practitioners
- S-CVI/Ave, Scale-level CVI of averaging calculation method
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Affiliation(s)
- Baharudin Abdullah
- Department of Otorhinolaryngology- Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Ramaprabah Kandiah
- Department of Otorhinolaryngology- Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Nik Fariza Husna Nik Hassan
- Department of Otorhinolaryngology- Head & Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Ahmad Filza Ismail
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Zahiruddin Wan Mohammad
- Department of Community Medicine, School of Medical Sciences, Universiti Sains Malaysia Health Campus, 16150 Kubang Kerian, Kelantan, Malaysia
| | - De Yun Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 119228, Singapore
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Yount KM, Cheong YF, Maxwell L, Heckert J, Martinez EM, Seymour G. Measurement properties of the project-level Women's Empowerment in Agriculture Index. World Dev 2019; 124:104639. [PMID: 31798204 PMCID: PMC6876673 DOI: 10.1016/j.worlddev.2019.104639] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
Women's empowerment is a process that includes increases in intrinsic agency (power within); instrumental agency (power to); and collective agency (power with). We used baseline data from two studies-Targeting and Realigning Agriculture for Improved Nutrition (TRAIN) in Bangladesh and Building Resilience in Burkina Faso (BRB)-to assess the measurement properties of survey questions operationalizing selected dimensions of intrinsic, instrumental, and collective agency in the project-level Women's Empowerment in Agricultural Index (pro-WEAI). We applied unidimensional item-response models to question (item) sets to assess their measurement properties, and when possible, their cross-context measurement equivalence-a requirement of measures designed for cross-group comparisons. For intrinsic agency in the right to bodily integrity, measured with five attitudinal questions about intimate partner violence (IPV) against women, model assumptions of unidimensionality and local independence were met. Four items showed good model fit and measurement equivalence across TRAIN and BRB. For item sets designed to capture autonomy in income, intrinsic agency in livelihoods activities, and instrumental agency in: livelihoods activities, the sale or use of outputs, the use of income, and borrowing from financial services, model assumptions were not met, model fit was poor, and items generally were weakly related to the latent (unobserved) agency construct. For intrinsic and instrumental agency in livelihoods activities and for instrumental agency in the sale or use of outputs and in the use of income, items sets had similar precision along the latent-agency continuum, suggesting that similar item sets could be dropped without a loss of precision. IRT models for collective agency were not estimable because of low reported presence and membership in community groups. This analysis demonstrates the use of IRT methods to assess the measurement properties of item sets in pro-WEAI, and empowerment scales generally. Findings suggest that a shorter version of pro-WEAI can be developed that will improve its measurement properties. We recommend revisions to the pro-WEAI questionnaire and call for new measures of women's collective agency.
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Key Words
- 2PL, two-parameter logistic
- Agricultural development
- BCC, Behavioral Change Communication
- BRB, Building Resilience in Burkina Faso
- CCC, Category Characteristic Curve
- CFA, confirmatory factor analysis
- CI, confidence interval
- DIF, differential item functioning
- EFA, exploratory factor analysis
- GAAP2, Gender, Agriculture, and Assets Project Phase 2
- GPI, gender parity index
- IPV, intimate partner violence
- IRT, item response theory
- Item response theory
- Measurement
- NRM, nominal response models
- RAI, Relative Autonomy Index
- Sustainable development goals
- TRAIN, Targeting and Realigning Agriculture for Improved Nutrition
- WEAI, Women’s Empowerment in Agriculture Index
- Women’s agency
- Women’s empowerment
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