The mediating role of emotion regulation difficulty between health anxiety and state anxiety in Iranian adults during Coronavirus pandemic

Document Type : Research Paper

Authors

1 Founder and faculty member of Iranian Emotion-Focused Therapy Institute, Tehran, Iran

2 M. A. student of clinical psychology, Faculty of Educational Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran

3 MS. in family counseling, Faculty of Educational Sciences and Psychology, Shahid Beheshti University of Tehran, Tehran, Iran

4 M. A. student of clinical psychology, Faculty of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran

Abstract

Introduction:  The aim of the present study was to investigate the mediating role of emotion regulation difficulties between health anxiety and state anxiety during coronavirus pandemic.
Materials and Methods: The present study is a descriptive-correlation of structural equations. The statistical population of the study includes all Iranian adults who lived in Mashhad between April and May 2020 from which 370 Iranian adults were selected as the sample by the convenient sampling method. The Spielberg State-Trait Anxiety Inventory (STAI), the Difficulties in Emotion Regulation Scale (DERS) and the Health Anxiety Inventory (HAI-18) were used. Data analyzed using Pearson correlation method and structural equation analysis.
Results: The results show that the components of health anxiety, which include getting sick (P=0.02), patient outcomes (P=0.02), and general health concerns (P=0.01), have a significant effect on state anxiety through the emotion regulation difficulties with effects of 0.27, 0.30 and -0.14, respectively. Increasing (decreasing) the getting sick and the patient outcomes components of health anxiety increases (decreases) the state anxiety by increasing (decreasing) the emotion regulation difficulties. However, increasing (decreasing) general health concerns lead to a decrease (increase) in state anxiety by decreasing (increasing) emotion regulation difficulty.
Conclusion: Individual who have higher subscales of "getting sick" and "patient outcomes" in health anxiety perceive more anxiety in situations where their health is at risk. But people with higher "general health concerns" subscale have better emotion regulation and perceive less anxiety in these situations.

Keywords

References

  1. Kahn N. New virus discovered by Chinese scientists investigating pneumonia outbreak. Wall Street Journal. [cited April 21, 2020]. Available from: https://www.kff.org/ news-summary/chinese-researchers-identify-novel-coronavirus-as-potentialcause-of-wuhan-pneumonia-outbreak/
  2. Gralinski LE, Menachery VD. Return of the Coronavirus: 2019-nCoV. Viruses 2020; 12(2): 135.
  3. Casale S, Flett GL. Interpersonally-based fears during the COVID-19 pandemic: Reflections on the fear of missing out and the fear of not mattering constructs. Clin Neuropsychiatry 2020; 17(2): 88-93.
  4. Bajema KL, Oster AM, McGovern OL, Lindstrom S, Stenger MR, Anderson TC, et al. Persons evaluated for 2019 novel coronavirus-United States, January 2020. MMWR Morb Mortal Wkly Rep 2020; 69(6): 166.
  5. Zandifar A, Badrfam R. Iranian mental health during the COVID-19 epidemic. Asian J Psychiatr 2020; 51: 101990.
  6. Cheng C. To be paranoid is the standard? Panic responses to SARS outbreak in the Hong Kong Special Administrative Region. Asian perspectives 2004; 28: 67-98.
  7. Puterman E, Delongis A, Lee-Baggley D, Greenglass E. Coping and health behaviours in times of global health crises: lessons from SARS and West Nile. Glob Public Health 2009; 4(1): 69-81.
  8. Al-Rabiaah A, Temsah M-H, Al-Eyadhy AA, Hasan GM, Al-Zamil F, Al-Subaie S, et al. Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) associated stress among medical students at a university teaching hospital in Saudi Arabia. J Infect Public Health 2020; 13(5): 687-91.
  9. Cheng C, Cheung MW. Psychological responses to outbreak of severe acute respiratory syndrome: A prospective, multiple time-point study. J Pers 2005; 73(1): 261-85.
  10. Wong LP, Hung C-C, Alias H, Lee TS-H. Anxiety symptoms and preventive measures during the COVID-19 outbreak in Taiwan. BMC Psychiatry 2020; 20(1): 1-9.
  11. Endler NS, Kocovski NL. State and trait anxiety revisited. J Anxiety Disord 2001; 15(3): 231-45.
  12. Marcus DK, Gurley JR, Marchi MM, Bauer C. Cognitive and perceptual variables in hypochondriasis and health anxiety: A systematic review. Clin Psychol Rev 2007; 27(2): 127-39.
  13. Owens KM, Asmundson GJ, Hadjistavropoulos T, Owens TJ. Attentional bias toward illness threat in individuals with elevated health anxiety. Cognit Ther Res 2004; 28(1): 57-66.
  14. Tyrer P. Recent advances in the understanding and treatment of health anxiety. Curr Psychiatry Rep 2018; 20(7): 49.
  15. Torales J, O’Higgins M, Castaldelli-Maia JM, Ventriglio A. The outbreak of COVID-19 coronavirus and its impact on global mental health. International Journal of Social Psychiatry. 2020:0020764020915212.
  16. Schimmenti A, Billieux J, Starcevic V. The four horsemen of fear: An integrated model of understanding fear experiences during the COVID-19 pandemic. Clinical Neuropsychiatry. 2020;17(2):41-5.
  17. Bareket-Bojmel L, Shahar G, Margalit M. COVID-19-Related Economic Anxiety Is As High as Health Anxiety: Findings from the USA, the UK, and Israel. International Journal of Cognitive Therapy. 2020:1.
  18. Werner K, Gross JJ. Emotion regulation and psychopathology: A conceptual framework. 2010: 13-37.
  19. Restubog SLD, Ocampo ACG, Wang L. Taking control amidst the chaos: Emotion regulation during the COVID-19 pandemic. J Vocat Behav2020; 119: 103440.
  20. Gross JJ. Emotion regulation: Affective, cognitive, and social consequences. Psychophysiol 2002; 39(3): 281-91.
  21. Rottenberg J, Gross JJ. Emotion and emotion regulation: A map for psychotherapy researchers. Clin Psychol Sci Pract 2007; 14(4): 323-8.
  22. Calkins SD. Commentary: Conceptual and methodological challenges to the study of emotion regulation and psychopathology. J Psychopathol Behav Assess 2010; 32(1): 92-5.
  23. Garcia-Batista ZE, Guerra-Pena K, Kandany VVN, Marte MI, Garrido LE, Cantisano-Guzman LM, et al. COVID-19 pandemic and health worker stress: The mediating effect of emotion regulation. medRxiv 2020; 06.19.20135574
  24. Eftekhari A, Zoellner LA, Vigil SA. Patterns of emotion regulation and psychopathology. Anxiety Stress Coping 2009; 22(5): 571-86.
  25. Bardeen JR, Fergus TA. An examination of the incremental contribution of emotion regulation difficulties to health anxiety beyond specific emotion regulation strategies. J Anxiety Disord 2014; 28(4): 394-401.
  26. Salkovskis PM, Warwick H. Meaning, misinterpretations, and medicine: A cognitive-behavioral approach to understanding health anxiety and hypochondriasis. New York: Oxford University; 2001: 202-22.
  27. Nargesi F, Izadi F, Kariminejad K, Rezaii Sharif A. [The investigation of the reliability and validity of Persian version of health anxiety questionnaire in students of Lorestan University of Medical Sciences]. Quarterly journal of educational measurement 2017; 7: 147-60. (Persian)
  28. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess 2004; 26(1): 41-54.
  29. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: A revised measure of psychological inflexibility and experiential avoidance. Behav Ther 2011; 42(4): 676-88.
  30. Azizi A, Mirzaei A, Shams J. [Correlation between distress tolerance and emotion regulation with students smoking dependence]. Hakim research journal 2010; 13(1): 11-18. (Persian)
  31. Besharat M, Bazzazian S. [Psychometric properties of the Cognitive Emotion Regulation Questionnaire in a sample of Iranian population]. Quarterly journal of nursing and midwifery of Shahid Beheshti University of Medical Sciences 2014; 24: 61-70 (Persian)
  32. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®). Washington. D.C.: American Psychiatric Association; 2013: 130-31.
  33. Spielberger CD. State-trait anxiety inventory for adults. Washington. D.C.:APA Psyc Tests; 1983.
  34. Taghavi M, Najafi M, Kianersi F, Aghayan S. [Comparing of alexithymia, defensive styles and state-trait anxiety among patients with generalized anxiety disorder major depression disorder and normal individuals]. Journal of clinical psychology 2013; 5(2): 67-76. (Persian)
  35. Korkmaz H, Korkmaz S, Yildiz S, Gündoğan B, Atmaca M. Determination of health anxiety, anxiety, and somatosensory amplification levels in individuals with normal coronary angiography. Psychiatry Res 2017; 252: 114-7.
  36. Buzsáki G. Evolution of thought and emotion. Curr Biol 2019; 29(19): R913-R4.
  37. Zargham Hajebi M, Pourabdol S, Beyki M, Sajjadpour SH. [The Role of Brain/Behavioral Systems and Emotion Processing in Predicting Social Anxiety of Students]. International journal of school health 2019; 6(3): 1-7.
  38. McRae K, Gross JJ. Emotion regulation. Emotion. 2020;20(1):1.
  39. Debeuf T, Verbeken S, Boelens E, Volkaert B, Van Malderen E, Michels N, et al. Emotion regulation training in the treatment of obesity in young adolescents: protocol for a randomized controlled trial. Trials. 2020;21(1):153.
  40. Robichaud M, Dugas MJ. The generalized anxiety disorder workbook: a comprehensive CBT guide for coping with uncertainty, worry, and fear. Oakland, USA: New Harbinger; 2015: 214-17.
  41. McLaughlin KA, Mennin DS, Farach FJ. The contributory role of worry in emotion generation and dysregulation in generalized anxiety disorder. Behav Res Ther 2007; 45(8): 1735-52.
  42. Hallion LS, Kusmierski SN, Caulfield MK. Worry alters speed-accuracy tradeoffs but does not impair sustained attention. Behav Res Ther 2020; 128: Article 103597.
Journal of Fundamentals of Mental Health
Volume 23, Issue 1
March and April 2021
Pages 31-39

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