Implicit and explicit COVID-19 associations and mental health in the United States: a large-scale examination and replication

Anxiety Stress Coping. 2023 Nov;36(6):690-709. doi: 10.1080/10615806.2023.2176486. Epub 2023 Feb 9.

Abstract

Background: Given the sensitive nature of COVID-19 beliefs, evaluating them explicitly and implicitly may provide a fuller picture of how these beliefs vary based on identities and how they relate to mental health.

Objective: Three novel brief implicit association tests (BIATs) were created and evaluated: two that measured COVID-19-as-dangerous (vs. safe) and one that measured COVID-19 precautions-as-necessary (vs. unnecessary). Implicit and explicit COVID-19 associations were examined based on individuals' demographic characteristics. Implicit associations were hypothesized to uniquely contribute to individuals' self-reports of mental health.

Methods: Participants (N = 13,413 US residents; April-November 2020) were volunteers for a COVID-19 study. Participants completed one BIAT and self-report measures. This was a preregistered study with a planned internal replication.

Results: Results revealed older age was weakly associated with stronger implicit and explicit associations of COVID-as-dangerous and precautions-as-necessary. Black and Asian individuals reported greater necessity of taking precautions than White individuals (with small-to-medium effects); greater education was associated with greater explicit reports of COVID-19-as-dangerous and precautions-as-necessary with small effects. Replicated relationships between COVID-as-dangerous explicit associations and mental health had very small effects.

Conclusions: Implicit associations did not predict mental health but there was evidence that stronger COVID-19-as-dangerous explicit associations are weakly associated with worse mental health.

Keywords: COVID-19; United States; anxiety; depression; implicit associations; mental health.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety* / psychology
  • Bias, Implicit
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • COVID-19* / psychology
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Mental Health*
  • Middle Aged
  • Pandemics
  • United States