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Tracing “Fearbola”: Psychological Predictors of Anxious Responding to the Threat of Ebola
Open accessAbstract
Serious illnesses such as Ebola are often highly publicized in the mass media and can be associated with varying levels of anxiety and compensatory safety behavior (e.g., avoidance of air travel). The present study investigated psychological processes associated with Ebola-related anxiety and safety behaviors during the outbreak in late 2014. Between October 30 and December 3, 2014, which encompassed the peak of concerns and of the media's attention to this particular outbreak, 107 university students completed a battery of measures assessing fear of Ebola, performance of safety behaviors, factual knowledge of the virus, and psychological variables hypothesized to predict Ebola-related fear. We found that while our sample was generally not very fearful of contracting Ebola, the fear of this disease was correlated with general distress, contamination cognitions, disgust sensitivity, body vigilance, and anxiety sensitivity-related physical concerns. Regression analyses further indicated that anxiety sensitivity related to physical concerns and the tendency to overestimate the severity of contamination were unique predictors of both Ebola fear and associated safety behaviors. Implications for how concerns over serious illness outbreaks can be conceptualized and clinically managed are discussed.
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“the CFI was constructed for the current study to assess participants’ level of fear concerning COVID-19.”
From Anxiety Sensitivity Mediates Relations Between Mental Distress Symptoms and Medical Care Utilization During COVID-19 Pandemic. (2021) · cites this paper as Blakey et al., 2015
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“As compared to previous pandemic studies, levels of AS-physical concerns in the present sample (M = 7.30, SD = 5.88) were significantly higher than those found by Wheaton et al. (2012): M = 3.63 (4.14), t(770) = 9.56, 95% CI [2.92, 4.42], p < .000; Blakey and Abramowitz (2017): M = 4.42 (4.52), t(671) = 6.36, 95% CI [1.99, 3.77], p < .000; and Blakey et al. (2015): M = 4.34 (4.29), t(562) = 4.91, 95% CI [1.78, 4.14], p < .001.”
From Anxiety Sensitivity Mediates Relations Between Mental Distress Symptoms and Medical Care Utilization During COVID-19 Pandemic. (2021) · cites this paper as Blakey et al. (2015)
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“Levels of safety behaviours in the current sample as measured by the CSBC (M = 41.09, SD = 5.65) were significantly higher than those measured with the Ebola Safety Behaviors Checklist (ESBC) in Blakey et al.’s (2015) study”
From Anxiety Sensitivity Mediates Relations Between Mental Distress Symptoms and Medical Care Utilization During COVID-19 Pandemic. (2021) · cites this paper as Blakey et al.’s (2015)
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“levels of AS-physical concerns in the present sample (M = 7.30, SD = 5.88) were significantly higher than those found by Wheaton et al. (2012)”
From Anxiety Sensitivity Mediates Relations Between Mental Distress Symptoms and Medical Care Utilization During COVID-19 Pandemic. (2021) · cites this paper as Blakey et al. (2015)
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“existing literature suggests that obsessive-compulsive contamination and/or health anxiety symptoms are associated with greater anxiety about prior public health concerns among university-affiliated samples (Wheaton et al., 2012; Blakey et al., 2015; Blakey and Abramowitz, 2017).”
From Ahead of the Curve: Responses From Patients in Treatment for Obsessive-Compulsive Disorder to Coronavirus Disease 2019 (2020) · cites this paper as Blakey et al., 2015
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InfluentialPsychological Predictors of Health Anxiety in Response to the Zika Virus
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InfluentialNikopoulou, V. A., Holeva, V., Parlapani, E., Karamouzi, P., Voitsidis, P., Porfyri, G.-N., Blekas, A., Papigkioti, K., Patsiala, S., & Diakogiannis, I. (2020) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-020-00414-w · Cited by 104
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BackgroundResultInfluentialCyberchondria in the age of COVID-19
Jokić‐Begić, N., Korajlija, A. L., & Mikac, U. (2020) · PLoS ONE · doi:10.1371/journal.pone.0243704 · Cited by 113
“The COVID-19 Safety Behaviour Checklist (CSBC) [10] is an eleven-item checklist inspired by the Ebola Safety Behaviour Checklist [20].”
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COVID Stress Syndrome: Clinical and Nosological Considerations
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The Italians in the Time of Coronavirus: Psychosocial Aspects of the Unexpected COVID-19 Pandemic
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“For example, a US study of 107 students during the Ebola outbreak reported a significant relationship between the ASI-3 physical concerns subscale and Ebola fear (Blakey et al., 2015).”
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“Several studies reported that disgust sensitivity was associated with concerns about past pandemic threats in undergraduate students in the USA, including the H1N1 Swine Flu (Brand et al., 2013; Wheaton et al., 2012) and Ebola (Blakey et al., 2015).”
BackgroundResultInfluentialThe Influence of COVID-19 on Stress, Substance Use, and Mental Health Among Postsecondary Students
Patterson, Z. R., Gabrys, R. L., Prowse, R., Abizaid, A. B., Hellemans, K. G. C., & McQuaid, R. J. (2021) · Emerging Adulthood · doi:10.1177/21676968211014080 · Cited by 85
“Moreover, constant exposure to news and information about COVID-19 has been associated with increased levels of stress and anxiety (Gao et al., 2020), an effect also seen during earlier pandemics and epidemics, such as the H1N1 flu and Ebola, respectively (Blakey et al., 2015; Wheaton et al., 2012).”
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“The Fear of COVID-19 was taken from Blakey et al. (2015), who adapted the Wheaton et al. (2012) scale.”
COVID‐19: Concerns and behaviours in Croatia
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“However, specific individual factors such as contamination fear and anxiety sensitivity were predictive of higher levels of anxiety over being infected by the Ebola virus (Blakey et al., 2015), despite the country having only 11 documented cases.”
BackgroundThe Impact of the Covid-19 Pandemic on Disgust Sensitivity
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“For example, greater AS-physical concerns and DS have been shown to be positively correlated with fear of Swine Flu (Wheaton et al., 2012), Ebola (Blakey et al., 2015), and Zika virus (Blakey & Abramowitz, 2017).”
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“This hasbeen studied during previous outbreaks of the swine flu (Wheaton et al., 2012), Zika (Blakey and Abramowitz, 2017), and Ebola (Blakey et al., 2015).”
BackgroundDisgust Sensitivity Among Women During the COVID-19 Outbreak
Miłkowska, K., Galbarczyk, A., Mijas, M. E., & Jasieńska, G. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.622634 · Cited by 41
“For instance, in a study on psychological processes associated with the Ebola outbreak in the 2014, the fear of the disease was associated with increased general distress, body vigilance, and disgust sensitivity (Blakey et al., 2015).”
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“Fear of contamination has been a key psychological factor in previous pandemic research (Blakey & Abramowitz, 2017; Blakey et al., 2015).”
BackgroundInstruments to measure fear of COVID-19: a diagnostic systematic review
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BackgroundInfluentialFear of COVID ‐19, stress and depression: A meta‐analytic test of the mediating role of anxiety
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“The 13- item of COVID- 19 Fear Inventory was developed based on Ebola Fear Inventory (Blakey et al., 2015) and Swine Flu Anxiety Items (Wheaton et al., 2012).”
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“Furthermore, previous research has demonstrated an association between worsening OCD symptoms and health anxiety during global pan-demics, such as the H1N1 ‘Swine Flu’ influenza (Brand et al., 2013), the Zika virus outbreak (Blakey & Abramowitz, 2017), and Ebola (Blakey et al., 2015).”
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“…conducted during the H1N1, Ebola and Zika virus pandemics have demonstrated that individuals with OCD symptoms, particularly those with high contamination OCD symptoms, were at risk of developing excessive pandemic-related fears (Brand et al., 2013; Wheaton et al., 2021; Blakey et al., 2015).”
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Response to the COVID-19 Outbreak in Urban Settings in China
Ni, Z., Lebowitz, E. R., Zou, Z., Wang, H., Liu, H., Shrestha, R., Zhang, Q., Hu, J., Yang, S., Xu, L., et al. (2020) · Journal of Urban Health · doi:10.1007/s11524-020-00498-8 · Cited by 21
DeGrace, S., Baptist-Mohseni, N., Single, A. N., Keough, M. T., Wardell, J. D., & Stewart, S. H. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.110834 · Cited by 20
“Individuals high in AS may misinterpret harmless physical sensations as related to the development of COVID-19, contributing to their heightened anxiety (Blakey et al., 2015).”
InfluentialKim, H. J., Meeker, T. J., Tulloch, I. K., Mullins, R. J., Park, J., & Bae, S. H. (2022) · International Journal of Public Health · doi:10.3389/ijph.2022.1604552 · Cited by 20
“Elevated trait AS was positively correlated with worry and fear of epidemic outbreaks during the Zika virus and Ebola virus epidemics [32, 33].”
Background“Touch Me If You Can!”: Individual Differences in Disease Avoidance and Social Touch
Thiebaut, G., Méot, A., Witt, A., Prokop, P., & Bonin, P. (2021) · Evolutionary Psychology · doi:10.1177/14747049211056159 · Cited by 22
“Thus, unlike most previous studies, which have focused on “hypothetical” pathogen threats, one strength of Study 2 is that we report people’s psychological responses to an actual threat (for previous studies on the impact of a real pathogen threat see, for example: Blakey and Abramowitz, 2017; Blakey et al., 2015; Sch…”
ResultGerms on a Plane: The Transmission and Risks of Airplane-Borne Diseases
Sevilla, N. L. (2018) · Transportation Research Record Journal of the Transportation Research Board · doi:10.1177/0361198118799709 · Cited by 18
Geographic charisma and the potential energy of Ebola
Herrick, C. (2019) · Sociology of Health & Illness · doi:10.1111/1467-9566.12960 · Cited by 18
“Accounts of Ebola in the mass media as well as in bestsellers such as The Hot Zone have thus been responsible for driving an epidemic of what Vice has termed ‘Fearbola’ (Blakey et al., 2015).”
BackgroundDowning, S. T., McCarty, R. J., Guastello, A. D., Cooke, D. L., & McNamara, J. P. H. (2022) · Psychology Health & Medicine · doi:10.1080/13548506.2022.2093925 · Cited by 17
“Questions assessing behaviour frequencies and PMT constructs were thematically similar to questions used in previous pandemic studies (Blakey et al., 2015; Bults et al., 2011; Rubin et al., 2009) and the COVID-19 Snapshot Monitoring (COSMO) protocol (Betsch et al., 2020).”
MethodSuspicious minds: cinematic depiction of distrust during epidemic disease outbreaks
Han, Q., & Curtis, D. R. (2020) · Medical Humanities · doi:10.1136/medhum-2020-011871 · Cited by 17
Guo, Y., Yang, H., Elhai, J., & McKay, D. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.713279 · Cited by 16
“Studies from prior virus outbreaks found that physical concern scores were associated with fear of contracting illness (42, 43).”
BackgroundWhat Psychological Factors Make Individuals Believe They Are Infected by Coronavirus 2019?
Daniali, H., & Flaten, M. A. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.667722 · Cited by 16
“This fits well with findings that health anxiety predicts hypochondriasis (e.g., Bleichhardt and Hiller, 2007; Faasse and Petrie, 2013; Jungmann and Witthöft, 2020).”
ResultThe relational calibration of fear
Harbin, A. (2022) · Synthese · doi:10.1007/s11229-022-03719-6 · Cited by 14
“While the research on demographic trends in COVID risk perception is early, we might anticipate that just as we have seen that knowledge about other crises (e.g., climate change) does not always predict higher perceptions of risk or more risk-averse decision making, since such perception and decision-making is often p…”
BackgroundJelinek, L., Voderholzer, U., Moritz, S., Carsten, H. P., Riesel, A., & Miegel, F. S. (2021) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2021.102493 · Cited by 13
Shook, N. J., Oosterhoff, B. J., & Sevi, B. (2023) · Vaccine · doi:10.1016/j.vaccine.2022.12.065 · Cited by 13
“, handwashing) during the 2014 Ebola outbreak [3].”
Backgroundshabani, M. J., Mohsenabadi, H., Gharraee, B., Shayanfar, F., Corcoran, V. P., & McKay, D. (2022) · International Journal of Cognitive Therapy · doi:10.1007/s41811-022-00152-y · Cited by 13
“These results are in line with previous studies on COVID-19 pandemic (Akbari et al., 2021; Dennis et al., 2021; Ojalehto et al., 2021; Taylor et al., 2020) and prior pandemic disease threats, which found that health anxiety symptoms are also related to the anxiety of contracting swine flu (Wheaton et al., 2012), SARS…”
BackgroundInfluentialHasan, M. K., Kabir, H., Rahman, M., Roy, A. K., Akter, S., & Mitra, D. K. (2021) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2021.100262 · Cited by 12
Xin, T., Li, X., Lei-Shen, Ding, W.-Y., WeiLiu, & Ning-Chen (2022) · Current Psychology · doi:10.1007/s12144-022-02860-2 · Cited by 12
Slivjak, E. T., Fishbein, J. N., Nealis, M. S., Schmiege, S. J., & Arch, J. J. (2021) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2021.1887430 · Cited by 11
Kim, H. S., Ahn, J., Lee, J., Hong, Y., Kim, C., Park, J., & Chung, S. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.899266 · Cited by 13
Khoury, J. M. B., Watt, M. C., & MacLean, K. (2021) · International Journal of Cognitive Therapy · doi:10.1007/s41811-021-00113-x · Cited by 10
“…anxiety and related symptoms would be elevated as compared to “normal” (non-pandemic), the first remarkable finding was the significant elevation in all symptoms as compared to the findings of previous pandemic studies (e.g., Blakey & Abramowitz, 2017; Blakey et al., 2015; Wheaton et al., 2012).”
BackgroundMethodResultInfluentialSadeghzadeh, M., Abbasi, M., Khajavi, Y., & Amirazodi, H. (2021) · Current Psychology · doi:10.1007/s12144-020-01237-7 · Cited by 11
Adaptation and psychometric evaluation of Hungarian version of the Fear of COVID-19 Scale
Stankovic, M., Papp, L., Nyúl, B., Ivánkovits, L., Pető, Z., & Töreki, A. (2021) · PLoS ONE · doi:10.1371/journal.pone.0261745 · Cited by 9
“Previous literature [4, 20, 22] supports the finding, that anxiety and depression are often comorbid with feelings of fear [19, 71], specifically fear during epidemics [15].”
ResultPhillips, P., & Cassidy, T. (2023) · Health Communication · doi:10.1080/10410236.2023.2169300 · Cited by 9
“…global press coverage is a feature of contemporary society, with news reports surrounding the risks of infectious diseases historically considered sensationalist, exemplified by terms such as “Fearbola” (Blakey et al., 2015; Eckert et al., 2018) circulating throughout contemporary discourse.”
BackgroundDixon, L. J., Witcraft, S. M., & Schadegg, M. J. (2021) · Journal of American College Health · doi:10.1080/07448481.2021.1923504 · Cited by 9
Pogue, J. R., da Graca, B., Adams, M., Kruegar, C., Patel, R., Bennett, M., Powers, M. B., & Warren, A. M. (2022) · Baylor University Medical Center Proceedings · doi:10.1080/08998280.2022.2034494 · Cited by 9
The Mental Health Impact of the COVID-19 Pandemic Second Wave on Shielders and Their Family Members
Daniels, J., & Rettie, H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19127333 · Cited by 8
“It is possible that what was measured in this study was behavioural compliance to pre-specified guidance, rather than idiosyncratic ‘safety-seeking’ behaviours, i.e., the measure may not have adequately captured excessive behaviours which are known to perpetuate distress in the anxiety model; or as observed in Blakey…”
BackgroundInfluentialDing, Y., Ji, T., & Guo, Y. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182212113 · Cited by 8
Yunus, F. M., Livet, A., Mahmoud, A., Moore, M., Murphy, C. B., Nogueira‐Arjona, R., Thompson, K., Keough, M. T., Krank, M. D., Conrod, P., et al. (2022) · Psych · doi:10.3390/psych4040069 · Cited by 8
7 science-based strategies to cope with coronavirus anxiety
Kecmanovic, J. (2020) · doi:10.64628/aai.6evrr6kkr · Cited by 8
Çeli̇k, E., Biçener, E., Bayın, Ü., & Uğur, E. (2022) · Anales de Psicología · doi:10.6018/analesps.469511 · Cited by 8
“As a matter of fact, in previous studies, it was found that anxiety sensitivity is associated with anxiety about H1N1 (Wheaton et al., 2011) and fear of Ebola (Blakey et al., 2015).”
BackgroundResultInfluentialMermin‐Bunnell, K., & Ahn, W. (2022) · PLoS ONE · doi:10.1371/journal.pone.0267735 · Cited by 7
Kuru, T., & Uymaz, P. (2020) · Acta Medica Alanya · doi:10.30565/medalanya.718083 · Cited by 7
Pinciotti, C. M., Piacsek, K., Kay, B., Bailey, B. E., & Riemann, B. C. (2021) · Bulletin of the Menninger Clinic · doi:10.1521/bumc_2021_85_04 · Cited by 7
Metadata
- Authors
- Blakey, S. M., Reuman, L., Jacoby, R. J., & Abramowitz, J. S.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Abramowitz, Jonathan S.
- Venue
- Cognitive Therapy and Research
- Published
- 2015-06-19
- Volume
- 39
- Issue
- 6
- Pages
- 816-825
- ISSN
- 0147-5916 (ISSN-L)
- 1573-2819
- PMC
- PMC7088101
- OpenAlex
- W1891769293
- Cited by
- 164
- References
- 46
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 8 · 2023: 16 · 2022: 37 · 2021: 54 · 2020: 34 · 2019: 4 · 2018: 3 · 2017: 1 · 2016: 1 · 2015: 1
- FWCI
- 3.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cognitive Therapy and Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Sociology and Political Science › Risk Perception and Management
- Keywords
- Ebola, safety behavior, anxiety sensitivity, disgust sensitivity, body vigilance, health anxiety, media coverage of epidemics, university students
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