Relationship between fear of coronavirus and death anxiety: Mediating role of behavioral inhibition system

Document Type : Research Paper

Authors

1 Associate professor, Department of Psychology, Faculty of Educational Science and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran

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

3 B. A. student in psychology, Faculty of Educational Science and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran

4 P h.D. student in counseling, Faculty of Educational Science and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran

Abstract

Introduction: Due to the increasing rate of coronavirus disease, the experience of high levels of fear and anxiety worldwide is predictable. In this regard, the results of previous studies have shown that each of the variables of fear of coronavirus and behavioral inhibition system plays a decisive role in predicting death anxiety. Therefore this study aimed to investigate the relationship between fear of coronavirus and death anxiety, and the mediating role of behavioral inhibition system in this regard.
Materials and Methods: The research method of this study was descriptive-correlation type and structural equations. The statistical population of this study included Iranian adults. Among them 605 people were selected by the available sampling method. Data were collected in July and August 2020 using the Templer death anxiety scale, fear of COVID-19 Scale, and the Carver and White BIS/BAS Scale in Mashhad, Iran. Data analysis was performed using the Pearson correlation method and path analysis.
 Results: The results showed that death anxiety was significantly associated with fear of coronavirus (P< 0.01) and the behavioral inhibition system (P< 0.01). Also, the mediating role of the behavioral inhibition system was confirmed at the level of 0.001.
 Conclusion: According to the findings of this study, fear of coronavirus can predict death anxiety through the mediating role of the behavioral inhibition system.

Keywords


1. Bogoch II, Watts A, Thomas-Bachli A, Huber C, Kraemer MU, Khan K. Pneumonia of unknown aetiology in Wuhan, China: potential for international spread via commercial air travel. J Travel Med 2020; 27(2): taaa008.
2. Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol 2020; 92(4): 401-2.
3. Ramos C. [Covid-19: la nueva enfermedad causada por un coronavirus]. Salud Pública de México 2020; 62(2): 22-27. (Spanish)
4. Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares
global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020; 76: 71-6.
5. Yousefi B, Valizadeh S, Ghaffari H, Vahedi A, Karbalaei M, Eslami M. A global treatments for coronaviruses including COVID-19. J Cell Physiol 2020; 235(12): 9133-42.
6. Rosenbaum L. Facing covid-19 in Italy-ethics, logistics, and therapeutics on the epidemic’s front line. N Engl J Med 2020; 382(20): 1873-75.
7. Asmundson GJ, Taylor S. Coronaphobia: Fear and the 2019-nCoV outbreak. J Anxiety Disord 2020; 70: 102196.
8. Lau JT, Griffiths S, Choi KC, Tsui HY. Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. BMC Infect Dis 2010; 10(1): 139.
9. Jalloh MF, Li W, Bunnell RE, Ethier KA, O’Leary A, Hageman KM, et al. Impact of Ebola experiences and risk perceptions on mental health in Sierra Leone, July 2015. BMJ Glob Health 2018; 3(2): e000471.
10. Wang C, Pan R, Wan X, Tan Y, Xu L, Ho CS, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int J Environ Res Public Health 2020; 17(5): 17-29.
11. Lee SA, Jobe MC, Mathis AA, Gibbons JA. Incremental validity of coronaphobia: Coronavirus anxiety explains depression ,generalized anxiety, and death anxiety. J Anxiety Disord 2020; 74: 102268.
12. Goulia P, Mantas C, Dimitroula D, Mantis D, Hyphantis T. General hospital staff worries, perceived sufficiency of information and associated psychological distress during the A/H1N1 influenza pandemic. BMC Infect Dis 2010; (10): 322.
13. Qiu J, Shen B, Zhao M, Wang Z, Xie B, Xu Y. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen Psychiatr 2020; 33(2): e100213.
14. Huang Y, Zhao N. Generalized anxiety disorder, depressive symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Res 2020; 288: 112954.
15. Lang PJ, Davis M, Öhman A. Fear and anxiety: animal models and human cognitive psychophysiology. J Affect Disord Rep 2000; 61(3): 137-59.
16. Asmundson GJ, Taylor S. How health anxiety influences responses to viral outbreaks like COVID-19: What all decision-makers, health authorities, and health care professionals need to know. J Anxiety Disord 2020; 71: 102211.
17.Jungmann SM, Witthöft M. Health anxiety, cyberchondria, and coping in the current COVID-19 pandemic: Which factors are related to coronavirus anxiety? J Anxiety Disord 2020; 73: 102239.
18. Song K, Li T, Luo D, Hou F, Bi F, Stratton TD, et al. psychological stress and gender differences during covid19 pandemic in chinese population. medRxiv 2020; 1. 1-23.
19. Ratcliffe M, Broome M. Existential phenomenology, psychiatric illness and the death of possibilities. Cambridge Companion to Existentialism 2012; 361-82.
20. Kesebir P. A quiet ego quiets death anxiety: Humility as an existential anxiety buffer. J Pers Soc Psychol 2014; 106(4): 610-23.
21. Malinauskaite I, Slapikas R, Courvoisier D, Mach F, Gencer B. The fear of dying and occurrence of posttraumatic stress symptoms after an acute coronary syndrome: a prospective observational study. J Health Psychol 2017; 22(2): 208-17.
22. Newton-John T, Menzies R, Chambers S, Menzies R. Psychological distress associated with covid-19: estimations of threat and the relationship with death anxiety. [cited 2020 May 4]. Available from://SSRN 3594629.
23. Menzies RE, Neimeyer RA, Menzies RG. Death anxiety, loss, and grief in the time of COVID-19. Behav Change 2020; 37(3): 111-5.
24. Lázaro-Pérez C, Martínez-López JÁ, Gómez-Galán J, López-Meneses E. Anxiety about the risk of death of their patients in health professionals in Spain: Analysis at the peak of the COVID-19 pandemic. Int J Environ Res Public Health 2020; 17(16): 3859.
25. Campbell-Sills L, Liverant GI, Brown TA. Psychometric evaluation of the behavioral inhibition/behavioral activation scales in a large sample of outpatients with anxiety and mood disorders. Psychol Assess 2004; 16(3):
244.
26. Turner SM, Beidel DC, Wolff PL. Is behavioral inhibition related to the anxiety disorders? Clin Psychol Rev 1996; 16(2): 157-72.
27. Corr PJ. Reinforcement sensitivity theory and personality. Neurosci Biobehav Rev 2004; 28(3): 317-32.
28. Gray J, McNaughton N. An enquiry into the functions of the septohippocampal system. The Neuropsychology of Anxiety. J Affect Disord 2000; 61(3): 161-76.
29. Pickering AD, Díaz A, Gray JA. Personality and reinforcement: An exploration using a maze-learning task. Pers Individ Dif 1995; 18(4): 541-58.
30. Franken IH, Muris P. BIS/BAS personality characteristics and college students’ substance use. Pers Individ Dif 2006; 40(7): 1497-503.
31. Gray J, McNaughton N. The neuropsychology of anxiety. New York: Oxford University; 2000: 72-82.
32. Scholten MR, van Honk J, Aleman A, Kahn RS. Behavioral Inhibition System (BIS), Behavioral Activation System (BAS) and schizophrenia: relationship with psychopathology and physiology. J Psychiatr Res 2006; 40(7): 638-45.
33. Taylor J, Eitle D. The moderating role of BIS/BAS personality tendencies in the relationship between general strain and crime. Deviant Behav 2015; 36(11): 874-89.
34. Kazerooni N, Akrami N. [Predicting death anxiety based on attachment styles and personality components proposed in the brain and behavioral systems approach]. Proceeding of the 3rd National Conference on Psychology and Behavioral Sciences, Aug 2015, Tehran, Iran: 426-30. (Persian)
35. Templer DI. The construction and validation of a death anxiety scale. J Gen Psychol 1970; 82(2): 165-77.
36. Aghajani M, Valiee S, Tol A. [Death anxiety amongst nurses in critical care and general wards]. Iranian journal of nursing 2011; 23(67): 59-68. (Persian)
37. Sharif Nia H, Ebadi A, Lehto RH, Mousavi B, Peyrovi H, Chan YH. Reliability and validity of the Persian version of Templer Death Anxiety Scale-extended in veterans of Iran-Iraq warfare. Iran J Psychiatry Behav Sci 2014; 8(4): 29-37.
38. Rajabi G, Bahrani M. [The analysis of death anxiety scale question]. Journal of psychology 2001; 5(4): 331-44. (Persian)
39. Montazeri A, Vahdaninia M, Ebrahimi M, Jarvandi S. The Hospital Anxiety and Depression Scale (HADS): Translation and validation study of the Iranian version. Health Qual Life Outcomes 2003; 1: 14.
40. Ahmadzadeh M, Ghamarani A, Samadi M, Shamsi A, Azizollah A. The investigation of validity and reliability of a scale of perceived vulnerability to disease in Iran. Br J Soc Sci 2013; 1(4): 43-51.
41. Duncan LA, Schaller M, Park JH. Perceived vulnerability to disease: Development and validation of a 15-item self-report instrument. Pers Individ Dif 2009; 47(6): 541-6.
42. Ahorsu DK, Lin C-Y, Imani V, Saffari M, Griffiths MD, Pakpour AH. The fear of COVID-19 scale:
development and initial validation. Int J Ment Health Addict 2020; 1-9.
43. Carver CS, White TL. Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: the BIS/BAS scales. J Pers Soc Psychol 1994; 67(2): 319-33.
44. Muris P, Meesters C, Spinder M. Relationships between child-and parent-reported behavioural inhibition and symptoms of anxiety and depression in normal adolescents. Pers Individ Dif 2003; 34(5): 759-71.
45. Mohammadi N. [The psychometric properties of the Behavioral Inhibition System (BIS) and Behavioral Activation System (BAS) scales among students of Shiraz University. Daneshvar Raftar 2008; 15(special issue): 61-68. (Persian)
46. Hasani J, Salehi S, Rasouli Azad M. [Psychometric properties of the Jackson five-factor questionnaire: Scales of revised sensitivity theory to reinforcement]. Research in psychological health 2012; 6(3): 60-73. (Persian)
47. Lee SA. Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety. Death Stud 2020; 44(7): 393-401.
48. Lee SA, Jobe MC, Mathis AA. Mental health characteristics associated with dysfunctional coronavirus anxiety. Psychol Med 2020; 16: 1-2.
49. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Net Open 2020; 3(3): e203976.
50. Lee SA, Mathis AA, Jobe MC, Pappalardo EA. Clinically significant fear and anxiety of COVID-19: A psychometric examination of the Coronavirus Anxiety Scale. Psychiatry Res 2020; 290: 113112.
51. Evren C, Evren B, Dalbudak E, Topcu M, Kutlu N. Measuring anxiety related to COVID-19: A Turkish validation study of the Coronavirus Anxiety Scale. Death Stud 2020; 1-7.
52. Hogg MA. Self-uncertainty, social identity, and the solace of extremism. In: Hogg MA, Blaylock DL. (editors). Extremism and the psychology of uncertainty. USA: Wiley-Blackwell; 2012: 19-35.
53. Scott BG, Weems CF. Natural disasters and existential concerns: A test of Tillich’s theory of existential anxiety. J Humanist Psychol; 53(1): 114-28.
54. Dong L, Bouey J. Public mental health crisis during COVID-19 pandemic, China. Emerg Infect Dis 2020; 26(7): 1616-18.
55. Li W, Yang Y, Liu Z-H, Zhao Y-J, Zhang Q, Zhang L, et al. Progression of mental health services during the COVID-19 outbreak in China. Int J Biol Sci 2020; 16(10): 17-32.
56. Caycho-Rodríguez T, Vilca LW, Carbajal-León C, White M, Vivanco-Vidal A, Saroli-Araníbar D, et al. Coronavirus Anxiety Scale: New psychometric evidence for the Spanish version based on CFA and IRT models in a Peruvian sample. Death Stud 2021; 1-10.
57. Rosenbaum JF, Biederman J, Gersten M, Hirshfeld DR, Meminger SR, Herman JB, et al. Behavioral inhibition in children of parents with panic disorder and agoraphobia: A controlled study. Arch Gen Psychiatry 1988; 45(5): 463-70.
58. Agroskin D, Jonas E, Klackl J, Prentice M. Inhibition underlies the effect of high need for closure on cultural closed-mindedness under mortality salience. Front Psychol 2016; 7: 1583.
59. Smits DJ, Kuppens P. The relations between anger, coping with anger, and aggression, and the BIS/BAS system. Pers Individ Dif 2005; 39(4): 783-93.
60. Harmon-Jones E, Gable PA. On the role of asymmetric frontal cortical activity in approach and withdrawal motivation: An updated review of the evidence. Psychophysiology 2018; 55: 1.
61. Yan C, Dillard JP. Emotion inductions cause changes in activation levels of the behavioural inhibition and approach systems. Pers Individ Dif 2010; 48(5): 676-80.
62. Sadiković S, Branovački B, Oljača M, Mitrović D, Pajić D, Smederevac S. Daily monitoring of emotional responses to the coronavirus pandemic in Serbia: A citizen science approach. Front Psychol 2020; 11: 21-33.
63. Kimbrel NA, Nelson-Gray RO, Mitchell JT. BIS, BAS, and bias: The role of personality and cognitive bias in social anxiety. Pers Individ Dif 2012; 52(3): 395-400.
64. Heidari P, Nemattavousi M. Behavioral inhibition/activation systems and self-esteem with depression: The mediating role of social anxiety. J Ration Emot Cogn Behav Ther 2021; 39: 375-89.