Cited by 300COVID-19 and Mental HealthCommunication and COVID-19 ImpactImpact of Technology on Adolescents

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Media use and acute psychological outcomes during COVID-19 outbreak in China

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Chao, Miao, Xue, Dini, Liu, Tour, Yang, Haibo, Hall, Brian J.·2020·Journal of Anxiety Disorders

DOI 10.1016/j.janxdis.2020.102248PMC PMC7255752

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Abstract

The COVID-19 outbreak in China led to an extraordinary threat to public health and wellbeing. This study examined the psychological impact of media use among people indirectly exposed to the disease during the initial phase of the outbreak. We conducted an internet-based survey on January 28, 2020 (one week after the official declaration of person-to-person transmission of the coronavirus). Media use (media forms, content of media exposure, and media engagement) related to the outbreak and psychological outcomes (positive and negative affect, anxiety, depression, and stress) of 917 Chinese adults was assessed. A series of multivariable regressions were conducted. The results showed that use of new media, rather than traditional media, was significantly associated with more negative affect, depression, anxiety, and stress. Viewing stressful content (i.e., severity of the outbreak, reports from hospital) was associated with more negative affect and depression. Media engagement was also associated with more negative affect, anxiety, and stress. However, viewing heroic acts, speeches from experts, and knowledge of the disease and prevention were associated with more positive affect and less depression. The study suggested new media use and more media engagement was associated with negative psychological outcomes, while certain media content was associated with positive psychological impact. The present study highlights the need for timely public health communication from official sources and suggests that reduced exposure to new media may be beneficial.

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“[15] Other studies in China also describe similar result that social media use time was associated with more depression, anxiety and stress.[25,26] The result of our study showed that social media exposure was associated with less likelihood to suffer from severe‐extremely severe depression, mild‐moderate and severe‐e…”
BackgroundResult
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“…indicate that exposure to COVID-19-related news and stressful content through media and/or social networking sites is associated with increased COVID-19-related worries and distress (Chao, Xue, Liu, Yang, &Hall, 2020; Mertens, Gerritsen, Duijndam, Salemink, &Engelhard, 2020; Roy et al., 2020).”
Background
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Self-citation
Salgın Hastalıklar Döneminde Sosyal Medyanın Korku Algısında Meydana Getirdiği Değişimin İncelenmesi: Covid-19/ Examination of The Change Caused by Social Media in The Perception of Fear During the Period of Epidemics: Covid-19
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Method
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BackgroundResult
When Infodemic Meets Epidemic: Systematic Literature Review
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Influential
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InfluentialSelf-citation
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“Studies have confirmed that the increased use of new media for information makes people more likely to feel depression, anxiety and stress during the pandemic (Chao et al., 2020).”
Background
A decline in perceived social status leads to post-traumatic stress disorder symptoms in adults half a year after the outbreak of the COVID-19 pandemic: consideration of the mediation effect of perceived vulnerability to disease
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“The public, under a state of panic and worry due to the newly discovered virus, was more subjected to the influences of explosive fake news and posts regarding transmission mechanisms of the disease and infection-prevention techniques, which could result in more stress and anxiety regarding the pandemic outbreak and i…”
Background
Exposure to COVID ‐19‐related media content and mental health during the initial outbreak of COVID ‐19 in China
Liu, T., Zhang, S., & Zhang, H. (2022) · Scandinavian Journal of Psychology · doi:10.1111/sjop.12805 · Cited by 4
“The results of ANOVA showed that media exposure was associated with positive and negative affect, which was consistent with previous studies (Chen, Liu, Li, Wei & Chao, 2020; Pillow & Mcnaughton Cassill, 2001; Veitch & Griffitt, 1976).”
ResultSelf-citation
Past lesson works: SARS memory moderates the relationship between media use and protective behavior during COVID-19 pandemic in China
Li, H., He, X., Hu, T.-Y., & Xie, X. (2022) · Journal of Health Psychology · doi:10.1177/13591053221105349 · Cited by 4
“The media effects model suggests that media use (e.g. media engagement and content of media exposure) causes changes in cognitions, emotions, attitudes, beliefs, physiological responses, and behaviors (Chao et al., 2020; Ren et al., 2021; Valkenburg and Peter, 2013; Wu and Shen, 2022).”
BackgroundInfluential
Immediate Effects of COVID-19 Outbreak on Psychiatric Outpatients: Post-traumatic Stress and Influencing Factors
Poyraz, B. Ç., Poyraz, C. A., Turan, Ş., Demirel, Ö. F., Kavla, Y., Bulu, E., Aydın, İ. H., & Ersungur, E. B. (2022) · Neuropsychiatric Investigation · doi:10.5152/neuropsychiatricinvest.2021.08-30 · Cited by 4
Reclaiming the Airwaves: Exploring the Motivations for FM Radio Listening during COVID-19
Menon, D. (2023) · Journal of Radio & Audio Media · doi:10.1080/19376529.2022.2145480 · Cited by 4
“During the pandemic, people increasingly relied on various mass media to keep them updated on the latest information about the pandemic and relieve their mental stress (Chao, Xue, Liu, Yang, & Hall, 2020).”
Notícias falsas em tempos de pandemia pelo novo coronavírus: uma análise documental
Piaui, U. F. D., Alencar, N. E. S., Lima, F. F. F., Gouvéia, M. T. D. O., & da Silva, G. R. F. (2021) · Revista CUIDARTE · doi:10.15649/cuidarte.1297 · Cited by 4
Learning Multimedia Management Strategy at Home During Learning from Home
Nugroho, B., Syakhrani, A. W., Hardiansyah, A., Pattiasina, P. J., & Pratiwi, E. Y. R. (2021) · Nidhomul Haq Jurnal Manajemen Pendidikan Islam · doi:10.31538/ndh.v6i3.1806 · Cited by 4
“This understanding of the ability to operate multimedia is reasonable because the subjects served from investments and schools are all using multimedia (Chao et al., 2020).”
Background
Assessment of Psychology, Behaviour and Self-Medication Potential Among Indian People During CovID-19 Pandemic
Sarkar, A., & Rajamani, J. I. (2021) · Biomedical & Pharmacology Journal · doi:10.13005/bpj/2329 · Cited by 3
Understanding actions and challenges in protecting older people during covid-19 pandemic in indonesia: A qualitative study with female caregivers
Asa, G. A., Fauk, N. K., Ratu, M., Dent, E., & Ward, P. (2023) · PLoS ONE · doi:10.1371/journal.pone.0273761 · Cited by 3
Differentiating the relationships between traditional and new media use and sleep quality during the COVID-19 pandemic: roles of psychological distress and age
Xu, T., Dongmei, Z., Yu, Z., Dang, J., & Schiöth, H. B. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1422004 · Cited by 3
Exploring the association between social and emotional skills and online social experiences: a network analysis and latent profile analysis
Yang, X., Yan, J., & Cui, Z. (2025) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2025.1582272 · Cited by 3
“According to the uses and grati ﬁ cations theory (23), individuals select media content based on their personal needs and motives, and they derive speci ﬁ c grati ﬁ cations from their media use, highlighting the role of individual differences in modifying media experiences.”
COVID-19 and the Vulnerabilities of Community-Dwelling Older Adults: Findings From a Statewide Survey of Home-Delivered Meals Recipients*
Masters, J., Wilkinson, L. R., Kelly, C., McKelvey, M. L., Saidi, L. G., Hill, T., Drozd, D. J., Wu, H., & O’Brien, T. (2022) · Gerontology and Geriatric Medicine · doi:10.1177/23337214221086465 · Cited by 3
“, radio, newspapers, and television), during the pandemic, has been linked to various psychological outcomes among adults (Chao et al., 2020).”
Background
How fear affects employees’ performance: A process model
Aleassa, H. M. (2023) · International Journal of Management and Sustainability · doi:10.18488/11.v12i1.3271 · Cited by 3
Between the Facts and a Hard Place: Trust Judgments and Affective Responses in Information-Seeking Processes During Early COVID-19
Pjesivac, I., Eldredge, S. A., Dalton, E. D., & Miller, L. E. (2023) · Health Communication · doi:10.1080/10410236.2023.2171561 · Cited by 3
“These information sources can be especially helpful in public health emergencies (Soroya et al., 2021), aiding people in making sense of the situation, learning precautionary measures, and reducing anxiety (Chao et al., 2020).”
Background
The 2018 California wildfires: examining sex differences in response to crisis communication and underlying processes
Lachlan, K. A., Gilbert, C., Hutter, E., & Spence, P. R. (2023) · Atlantic Journal of Communication · doi:10.1080/15456870.2023.2173363 · Cited by 3
Association of Systemic Family Dynamics and Well-Being During the COVID-19 Outbreak: A Cross-Sectional Survey
Xu, J., Yue, J.-L., Zhang, T., Wang, Z., Shi, L., Lu, L., & Zhao, X. (2023) · Journal of Family Issues · doi:10.1177/0192513x221150985 · Cited by 3
“For instance, they found that being married and having a background in medicine or psychology were protective factors for well-being (Cai et al., 2020; Chao, Xue, Liu, Yang, & Hall, 2020; Lopez et al., 2020; Morales-Vives, Dueñas, Vigil-Colet, & Camarero-Figuerola, 2020).”
Background
Transcultural Comparison of Mental Health and Work–Life Integration Blurring in the Brazilian and Spanish Populations during COVID-19
Pinzón, J. H., da Silva, A. M. B., Machado, W. D. L., Moret‐Tatay, C., & de Oliveira, M. Z. (2023) · Journal of Personalized Medicine · doi:10.3390/jpm13060955 · Cited by 4
“Although this approach can be positive in maintaining employment during a public calamity, it can also have negative effects, such as overexposure to social media [9], increased fear of COVID-19 [10], increased work demands, anxiety, stress, depression, among others [11].”
Background
Unequal Effects of the Lockdown on Mental Health in Shanghai: The Moderating and Mediating Role of Neighborhood Environment and Online Social Connections
Pei, Y., Qi, X., Li, G., Tang, W., Huang, K., Hall, B. J., & Wu, B. (2025) · Journal of Community Psychology · doi:10.1002/jcop.23177 · Cited by 3
Self-citation
The Question of Technology and Media in the Current Pandemic
Iacob, A. (2020) · Sæculum · doi:10.2478/saec-2020-0013 · Cited by 3
The Role of Social Media in Preventing the COVID-19 Pandemic
Konaç, A., & Barut, Y. (2021) · Advances in linguistics and communication studies · doi:10.4018/978-1-7998-6825-5.ch026 · Cited by 3
The association between facets of mindfulness and COVID-19 related distress: A cross-sectional study
Boekhorst, M. G. B. M., & Duijndam, S. (2023) · Acta Psychologica · doi:10.1016/j.actpsy.2023.103826 · Cited by 2
“Indeed, some findings suggest that looking up additional information through different media sources during the COVID-19 pandemic (Chao et al., 2020; Garfin et al., 2020; Mertens, Duijndam, et al., 2020), and earlier pandemics (e.”
Background
Koronavirüs (COVID-19) Pandemisinde Türk Toplumunun Dijital Teknoloji Kullanımı, Fiziksel Aktivite Düzeyi, Ruhsal Sağlığı ve Uyku Kalitesi
Mustafaoğlu, R., Yasacı, Z., KIRIKÇU, E., ÖREN, F., Tekin, M. E., ÖZPAZAR, R., TANRIKULU, Y., Şevval, U. Z. M. A., BUYURAN, D., & DENİZ, H. (2023) · Harran Üniversitesi Tıp Fakültesi Dergisi · doi:10.35440/hutfd.1286600 · Cited by 2
The effect of fear on health information searching behavior during the pandemic: The case of COVID-19
Teleş, M. (2024) · International Journal of Medical Informatics · doi:10.1016/j.ijmedinf.2024.105368 · Cited by 2
Psychological education in higher education: Opportunities and challenges in the Internet+ era
Zhang, H., & Yu, Y. (2025) · World Journal of Psychiatry · doi:10.5498/wjp.v15.i5.103274 · Cited by 2
Examining users’ emotional responses to YouTube content during the Covid-19 crisis: A cross-country experiment
Papa, V., Constantinou, E., & Lamprianou, I. (2025) · Communications · doi:10.1515/commun-2024-0137 · Cited by 2
“Chao et al. (2020) found that, during the early stages of the pandemic, information about the severity of the outbreak or the strain on the healthcare system increased distress, whereas information about the disease and its prevention was associated with lower levels of depression.”
Influential
Communication access, public health information sources, and language preference during the COVID-19 pandemic in Indigenous communities in Northwest Territories, Canada
Harris, R. M., Kolahdooz, F., Omidimorad, A., Wagg, A., DeLancey, D., Kandola, K., Pirkola, S. P., Irlbacher‐Fox, S., Corriveau, A., & Sharma, S. (2025) · PLoS ONE · doi:10.1371/journal.pone.0330394 · Cited by 2
Media Literacy as Resilience: A Conceptual Framework
Pasitselska, O., & Neag, A. (2026) · Media and Communication · doi:10.17645/mac.11458 · Cited by 3
“Chao et al. (2020) demonstrate that the use of new media, in contrast to traditional media during the Covid‐19 pandemic, was significantly associated with depression, anxiety, and stress.”
The Change of Public Individual Prevention Practice and Psychological Effect From the Early Outbreak Stage to the Controlled Stage of COVID-19 in China in 2020: Two Cross-Sectional Studies
Han, B., Liu, H., Zhao, T., Liu, B., Zheng, H., Wan, Y., & Cui, F. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.658571 · Cited by 2
The Complex Media Effects on Civic Participation Intention Amid COVID-19 Pandemic: Empirical Evidence from Wuhan College Students
Li, X., Fu, P., & Li, M. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph191711140 · Cited by 4
“The concept of “infodemic” has been used to emphasize on the overflood of information, with the intention to examine its negative impact on individuals’ mental health [2,8,33].”
BackgroundResultInfluential
Student stress and worry related to distance education during the COVID-19 pandemic
Zvekić-Svorcan, J., Šarenac, J., Kovačević, M., Vukliš, D., Krasnik, R., Mikić, A., Mikov, J., & Mikov, I. (2023) · The Journal of Infection in Developing Countries · doi:10.3855/jidc.16922 · Cited by 2
Impact of COVID-19 on Social Policy: A Literature Review in the Social and Human Sciences
Nassimov, M. O., Паридинова, Б. Ж., & Abikenov, Z. (2023) · Problemy Polityki Społecznej. Studia i Dyskusje · doi:10.31971/pps/171624 · Cited by 2
“In a study by Chao, Xue, Liu, Yang, and Hall, (2020), the use of new media is significantly associated with more negative effects, including depression, anxiety, and stress.”
Background
Decomposing Cultural Adaptation and Social Support in Relation to New Media Use and Psychological Well-Being Among Immigrants: a Chain Mediation Model
Bolaji, D. A., Wu, Y., & Akintunde, T. Y. (2024) · Applied Research in Quality of Life · doi:10.1007/s11482-024-10295-z · Cited by 2
“…technologies are core elements of computer-mediated technologies facilitating digitial communication innovations and promoting interactions between users (Chao et al., 2020), they channeled severe psychological vulnerabilities of global magnitude during the COVID-19 crisis (Akintunde et al., 2021).”
Influential
Modeling precaution, immunity loss and dispersal on disease dynamics: a two-patch SIRS model
Sun, G., Mai, A., & Jin, Z. (2025) · Advances in Continuous and Discrete Models · doi:10.1186/s13662-024-03862-z · Cited by 2
“For example, a study by Chao et al. [8] demonstrated that timely access to public health information from oﬃcial sources and reduced exposure to new media are beneﬁcial for preventing and controlling COVID-19.”
A global survey on the associations between the lockdown group, free memory recall and emotional responses during the COVID-19 lockdown
Oyejide, A. O., Besharati, S. N., Alcock, S., Schiöth, H. B., & Brooks, S. J. (2025) · Scientific Reports · doi:10.1038/s41598-025-91991-0 · Cited by 2
“This finding is consistent with recent studies that postulated the significant association of increasing misinformation, conspiracy theories, and fake news on COVID-19 infections and outcomes with heightened emotional and psychological responses 62,63 .”
Media, informacja a szczepienia przeciw COVID-19
Bałandynowicz-Panfil, K. (2021) · Media Biznes Kultura · doi:10.4467/25442554.mbk.21.023.15164 · Cited by 2
Role of Science, technology and innovation for responding to Covid-19
Panja, A., & Choudhury, S. M. (2022) · Asian Journal of Medical Sciences · doi:10.3126/ajms.v13i3.41543 · Cited by 2
“Most importantly, individuals should limit repeated exposure to media coverage of the pandemic and other painful social proceedings and should try to evade their work burden [39-41].”
Background
The Relationship Between Anxiety and Perceived Social Support at the Initial Stage of Covid-19 Outbreak
Güloğlu, B. (2022) · Journal of Psychiatric Nursing · doi:10.14744/phd.2021.52386 · Cited by 3
COVID-19 related information seeking: The impact of media on parental concerns
Arnaud, Y., Drouin, O., & Silva, R. B. D. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.977634 · Cited by 3
“Nevertheless, this constantly changing and contradictory plethora of news has the potential to affect people’s mental health and well-being (10).”
BackgroundResult
What Are the Differences in Psychological Outcomes Between People Who Posted COVID-19-Related Content on Social Media and Those Who Did Not?
Zhang, S., Zhang, Y., Xue, D., Zhang, H., Chao, M., & Liu, T. (2023) · Psychiatry Investigation · doi:10.30773/pi.2022.0146 · Cited by 2
Self-citation
Influence of Social Media on the Behavioral Formation of Digital Natives: a Moderation Approach
Gbadeyan, B. T., & Bayrakktar, Ü. A. (2023) · Journal of Law and Sustainable Development · doi:10.55908/sdgs.v11i10.1334 · Cited by 2
University students' perceived information overload mediates smartphone immediate response syndrome during COVID-19 outbreak: Taking the perspective of personality
Hong, J., Wei, Q., Li, Y., Zhan, Z., Zou, X., & Zhong, C. (2023) · Innoeduca International Journal of Technology and Educational Innovation · doi:10.24310/innoeduca.2023.v9i2.15593 · Cited by 3
Internet-Based Media as Information Sources in Risk Communication: Comparing Three Media Sources During COVID-19 Pandemic
Wu, F., Yang, T., Zhang, C., Yu, Y., & Xu, D. (2024) · Journalism Practice · doi:10.1080/17512786.2024.2308524 · Cited by 2
“Chao et al. (2020) found that individuals who viewed media content depicting people being heroic experienced more positive affect, whereas coverage concerning the severity of the outbreak and reports from hospitals increased negative affect.”
A koronavírusjárvány-helyzet pszichológiai hatásai és azok enyhítése – áttekintő közlemény 441 magyar felnőtt véleményével
Szabó, C., Pukánszky, J., & Kemény, L. V. (2020) · Egészségfejlesztés · doi:10.24365/ef.v61i4.633 · Cited by 2

Authors: Chao, M., Xue, D., Liu, T., Yang, H., & Hall, B. J.
Affiliations: Tianjin Normal University (CN)
University of Macau (MO)
Corresponding author: Liu, Tour
ORCID: Chao, Miao
Xue, Dini
Liu, Tour
Yang, Haibo
Hall, Brian J.
Venue: Journal of Anxiety Disorders
Publisher: Elsevier BV
Published: 2020-08
Volume: 74
Pages: 102248
ISSN: 0887-6185 (ISSN-L)
DOI: 10.1016/j.janxdis.2020.102248
PMC: PMC7255752
OpenAlex: W3029774798
Cited by: 300
References: 44
Citations by year: 2026: 17 · 2025: 24 · 2024: 27 · 2023: 55 · 2022: 63 · 2021: 84 · 2020: 30
FWCI: 21.87
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: Journal of Anxiety Disorders (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: Tianjin Philosophy and Social Science Project (TJJX15-002, 18YJC190013)
Projects of Humanities and Social Sciences, Ministry of Education of China
Topics: Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Social Sciences › Communication › Communication and COVID-19 Impact
Social Sciences › Sociology and Political Science › Impact of Technology on Adolescents
Keywords: COVID-19 pandemic, media use, psychological outcomes, anxiety, depression, stress, negative affect, positive affect, new media, media engagement, public health communication, indirect exposure, Chinese adults
MeSH terms: COVID-19, Adult, Anxiety, China, Depression, Disease Outbreaks, Female, Health Education, Humans, Male, Pneumonia, Viral, Public Health, Surveys and Questionnaires, Stress, Psychological, Coronavirus Infections, Internet, Pandemics

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Media use and acute psychological outcomes during COVID-19 outbreak in China

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