Anxiety Sensitivity Mediates Relations Between Mental Distress Symptoms and Medical Care Utilization During COVID-19 Pandemic.

“Both the subscales and the overall measure have been found to have acceptable internal consistency, construct validity, and convergent and discriminant validity (Henry & Crawford, 2005).”

“In their systematic review of COVID-19 studies conducted in Europe and Asia, Salari et al. (2020) reported elevated levels of stress (29.6% of the sample), anxiety (31.9%), and depression (33.7%), suggesting a need to focus not only on physical health concerns but also mental health concerns during the COVID-19 pandem…”

“On the other hand, testing AS-physical concerns and IU in a simple mediation model would have its own limitations (see Hayes, 2018).”

“According to the CDC (Czeisler et al., 2020), 40.9% of American adults reported at least one mental health condition (i.e., depression, anxiety, trauma) as a result of the pandemic.”

“Intolerance of Uncertainty Scale-12 (IUS-12; Carleton et al., 2007) The IUS-12 is a 12- item self-report questionnaire measuring how troubled respondents are by uncertainty.”

“The ASI-3 has strong internal consistency and convergent, discriminant, and criterion-related validity (Taylor et al., 2007).”

“…anxiety has not been assessed in previous pandemic studies although recent reports from India indicate that panic, along with anxiety, depression, sleep disturbances, and a sense of loneliness are increasing among the general population during the pandemic (Iqbal & Dar, 2020; Roy et al., 2020).”

“Short Health Anxiety Inventory (SHAI; Salkovskis et al., 2002) The SHAI is an 18-item measure of health anxiety, composed of two sections.”

“Secondly, its rate of transmission is much higher and more insidious — an infected person can transmit it when pre-symptomatic, asymptomatic, or exhibiting only mild symptoms (Gates, 2020).”

“During the SARS epidemic, self-isolation was found to predict high rates of depression (Liu et al., 2012).”

“Similarly, IU has been linked to various psychological disorders, including anxiety, depression, obsessive-compulsive disorder, and eating disorders (Carleton et al., 2012; Renjan et al., 2016; Toffolo et al., 2014).”

“Thirdly, austere regulations, at a level unique to the current pandemic (e.g., significantly reduced in-person contact; Groarke et al., 2020; governmentally enforced social distancing policies; Lipton & Steinhauer, 2020), also may be contributing to mental health issues as, for many, they have…”

“Whereas AS is a specific fear of physiological arousal (i.e., “fear of fear”; Reiss & McNally, 1985), IU is a more general fear of the unknown (Buhr & Dugas, 2009; Carleton, 2016).”

“High AS, for example, has been linked to anxiety, especially panic and health anxiety, as well as related disorders, including mood, stress, PTSD, and substance use (see Olatunji et al., 2009; Olatunji & Wolitzky-Taylor, 2009).”

“…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).”

“Whereas AS is a specific fear of physiological arousal (i.e., “fear of fear”; Reiss & McNally, 1985), IU is a more general fear of the unknown (Buhr & Dugas, 2009; Carleton, 2016).”

“CBT-targeting IU (CBT-IU) has been found to be effective in treating generalized anxiety disorder (Dugas et al., 2003; Gosselin et al., 2006).”

“At the same time, other researchers found that people with poor tolerance for uncertainty experienced the greatest anxiety and were less likely to believe they could do anything to protect themselves (Taha et al., 2014).”

“Individuals inclined to be health anxious commonly engage in reassurance- and safety-seeking behaviours, as well as greater utilization of healthcare services (see Barsky et al., 2001; Conroy et al., 1999; Creed, 2011; Fergus et al., 2015, Rask et al., 2016).”

“Medical Utilization Questionnaire (MUQ; Abramowitz et al., 2007) The original MUQ assesses utilization of both professional healthcare (emergency and specialist physicians; 20 items) and 10 self-care resources (e.”

“The SHAI has strong psychometric properties (Alberts et al., 2013).”

“…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).”

“…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).”

“McKay et al. (2020) found that the AS-physical concerns predicted COVID-19-related health anxiety, and both Tull et al. (2020) and Wheaton et al. (2020) found associations between IU and health anxiety concerning COVID-19.”

“Moreover, there is some evidence to suggest that individuals can accurately report their mental health symptoms (see Stuart et al., 2014).”

“Recently, Norr et al. (2015) investigated AS and IU as potential risk factors for “cyberchondria”.”

“CBT-targeting IU (CBT-IU) has been found to be effective in treating generalized anxiety disorder (Dugas et al., 2003; Gosselin et al., 2006).”

“This is particularly true for anxiety symptoms, which contributes to higher rates of initial medical care utilization and longer delays in accessing effective psychological interventions with anxiety (vs. mood) disorder populations (Deacon et al., 2008).”

“Both AS and IU are commonly associated with health anxiety (see Wright et al., 2016), which is a prominent focus of most studies on pandemic fears.”

“Interventions designed to reduce AS, such as Watt and Stewart’s (2008) brief cognitive behavioural therapy (CBT-AS), have been found to yield positive effects across disorders (see Olthuis et al., 2014, 2015; Watt et al., 2005, 2006).”

“Interventions designed to reduce AS, such as Watt and Stewart’s (2008) brief cognitive behavioural therapy (CBT-AS), have been found to yield positive effects across disorders (see Olthuis et al., 2014, 2015; Watt et al., 2005, 2006).”

“McKay et al. (2020) found that the AS-physical concerns predicted COVID-19-related health anxiety, and both Tull et al. (2020) and Wheaton et al. (2020) found associations between IU and health anxiety concerning COVID-19.”

“McKay et al. (2020) found that the AS-physical concerns predicted COVID-19-related health anxiety, and both Tull et al. (2020) and Wheaton et al. (2020) found associations between IU and health anxiety concerning COVID-19.”

“Fergus and Bardeen (2013) found that both AS and IU concurrently predicted health anxiety beyond both negative affect and each other, but concluded that AS-physical concerns may play a more critical role in the etiology of health anxiety than IU.”

“COVID-19 Fear Index (CFI) Following from the work of previous pandemic researchers (Blakey & Abramowitz, 2017; Blakey et al., 2015; Brand et al., 2013; Wheaton et al., 2012), the CFI was constructed for the current study to assess participants’ level of fear concerning COVID-19.”

“It is possible that the IU inhibitory dimension (vs. prospective dimension, see Norr et al., 2014) could further explicate relations between mental distress symptoms and behavioural responding and possibly yield an avoidance effect.”

“These can include emotional distress (Allan et al., 2015), social anxiety (Taylor et al., 2007), physical exercise (Sabourin et al., 2011), and sexual activity (Gerrior et al., 2015).”

“High AS, for example, has been linked to anxiety, especially panic and health anxiety, as well as related disorders, including mood, stress, PTSD, and substance use (see Olatunji et al., 2009; Olatunji & Wolitzky-Taylor, 2009).”

“Individuals inclined to be health anxious commonly engage in reassurance- and safety-seeking behaviours, as well as greater utilization of healthcare services (see Barsky et al., 2001; Conroy et al., 1999; Creed, 2011; Fergus et al., 2015, Rask et al., 2016).”

“Individuals inclined to be health anxious commonly engage in reassurance- and safety-seeking behaviours, as well as greater utilization of healthcare services (see Barsky et al., 2001; Conroy et al., 1999; Creed, 2011; Fergus et al., 2015, Rask et al., 2016).”

“Interventions designed to reduce AS, such as Watt and Stewart’s (2008) brief cognitive behavioural therapy (CBT-AS), have been found to yield positive effects across disorders (see Olthuis et al., 2014, 2015; Watt et al., 2005, 2006).”

“Similarly, IU has been linked to various psychological disorders, including anxiety, depression, obsessive-compulsive disorder, and eating disorders (Carleton et al., 2012; Renjan et al., 2016; Toffolo et al., 2014).”

“Physical exercise is known to be beneficial for individuals with high AS, especially women (see DeWolfe et al., 2019).”

“Effects have been found to last up to 14 weeks (Sabourin et al., 2015, 2016).”

“Individuals inclined to be health anxious commonly engage in reassurance- and safety-seeking behaviours, as well as greater utilization of healthcare services (see Barsky et al., 2001; Conroy et al., 1999; Creed, 2011; Fergus et al., 2015, Rask et al., 2016).”

“These can include emotional distress (Allan et al., 2015), social anxiety (Taylor et al.”

“Interventions designed to reduce AS, such as Watt and Stewart’s (2008) brief cognitive behavioural therapy (CBT-AS), have been found to yield positive effects across disorders (see Olthuis et al., 2014, 2015; Watt et al., 2005, 2006).”

“Similarly, IU has been linked to various psychological disorders, including anxiety, depression, obsessive-compulsive disorder, and eating disorders (Carleton et al., 2012; Renjan et al., 2016; Toffolo et al., 2014).”

“The PAQ-IV has strong concurrent validity (Norton et al., 2008).”

“Horenstein et al. (2019) found that health anxiety was associated with greater odds of seeking general medical care over the past 6 months among individuals with elevated levels of both AS and IU.”

“The defining characteristics of pandemics — global reach, unexpected emergence, invisibility, involuntary exposure, and potential lethality — are bound to trigger greater fear and uncertainty than do more familiar threats, such as influenza (Balderston et al., 2013).”

“These can include emotional distress (Allan et al., 2015), social anxiety (Taylor et al., 2007), physical exercise (Sabourin et al., 2011), and sexual activity (Gerrior et al., 2015).”

“Effects have been found to last up to 14 weeks (Sabourin et al., 2015, 2016).”

“…as measured by the IUS-12 was significantly higher in this sample (M = 33.34, SD = 10.43) as compared to results reported by O’Bryan and McLeish (2017): M = 29.57 (9.39), t(1080) = 6.22, 95% CI [2.58, 4.96], p < .000, and in Carleton et al.’s (2012) community-based sample:…”

“…anxiety has not been assessed in previous pandemic studies although recent reports from India indicate that panic, along with anxiety, depression, sleep disturbances, and a sense of loneliness are increasing among the general population during the pandemic (Iqbal & Dar, 2020; Roy et al., 2020).”

“Research shows that people are more apt to seek out medical (vs. psychological) services for mental health problems (see Murdoch et al., 2015).”

“Individuals inclined to be health anxious commonly engage in reassurance- and safety-seeking behaviours, as well as greater utilization of healthcare services (see Barsky et al., 2001; Conroy et al., 1999; Creed, 2011; Fergus et al., 2015, Rask et al., 2016).”

“…of the COVID-19 pandemic have demonstrated the important role that HA and anxiety-related constructs (e.g., anxiety sensitivity), or lack thereof, play in shaping behavioural responses to viral outbreaks (e.g., Akbari et al., 2021; Khoury et al., 2021; Kibbey et al., 2020; Sauer et al., 2020).”

“Improvements to intolerance of uncertainty are particularly notable given the robust literature concerning associations between the COVID-19 pandemic and increased intolerance of uncertainty (Khoury et al., 2021; Parlapani et al., 2020; Satici et al., 2022).”

“COVID-19 specific work has found that anxiety sensitivity increases the risk of anxiety and depressive symptoms (Mcleish et al., 2022; Warren et al., 2021) and maladaptive coping (Khoury et al., 2021; Manning et al., 2021; Mayorga et al., 2022; Zvolensky et al., 2024).”

“…be significantly negatively associated with fre - quency of cannabis use (see Krank et al., 2011), and that this protective association between AS and frequency of cannabis use would be mediated by increased PBS-M use given that AS can motivate health protective behaviors (Khoury et al., 2021 ).”

“In 2021, approximately two-thirds of individuals in the United States were experiencing moderate or severe psychological distress including elevated anxiety [2,3], depression [4], and loneliness [5].”