Worry, avoidance, and coping during the COVID-19 pandemic: A comprehensive network analysis

J Anxiety Disord. 2020 Dec:76:102327. doi: 10.1016/j.janxdis.2020.102327. Epub 2020 Oct 24.

Abstract

Background: Many psychological factors play a role in the COVID-19 pandemic, including various forms of worry, avoidance, and coping. Adding to the complexity, some people believe the threat of COVID-19 is exaggerated. We used network analysis to investigate how these diverse elements are interrelated.

Methods: A population-representative sample of 3075 American and Canadian adults completed an online survey, including measures of COVID-19-related worry, avoidance, self-protective behaviors, and other variables.

Results: The network contained three major hubs, replicated across gender and age groups. The most important hub centered around worries about the dangerousness of COVID-19, and formed the core of the previously identified COVID Stress Syndrome. The second most important hub, which was negatively correlated with the first hub, centered around the belief that the COVID-19 threat is exaggerated, and was associated with disregard for social distancing, poor hand hygiene, and anti-vaccination attitudes. The third most important hub, which was linked to the first hub, centered around COVID-19-related compulsive checking and reassurance-seeking, including self-protective behaviors such as panic buying and use of personal protective equipment.

Conclusion: Network analysis showed how various forms of worry, avoidance, coping, and other variables are interrelated. Implications for managing disease and distress are discussed.

Keywords: Anti-vaccination attitudes; COVID Stress Syndrome; COVID-19; Network analysis; Panic buying; Social distancing.

MeSH terms

  • Adaptation, Psychological*
  • Adolescent
  • Adult
  • Aged
  • Anxiety / epidemiology*
  • Attitude
  • COVID-19
  • COVID-19 Vaccines
  • Canada / epidemiology
  • Compulsive Behavior
  • Coronavirus Infections / epidemiology*
  • Coronavirus Infections / prevention & control
  • Coronavirus Infections / psychology*
  • Female
  • Health Behavior*
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Male
  • Middle Aged
  • Pandemics
  • Panic
  • Personal Protective Equipment
  • Pneumonia, Viral / epidemiology*
  • Pneumonia, Viral / psychology*
  • Stress, Psychological / epidemiology
  • Surveys and Questionnaires
  • United States / epidemiology
  • Viral Vaccines
  • Young Adult

Substances

  • COVID-19 Vaccines
  • Viral Vaccines