Incremental validity of coronaphobia: coronavirus anxiety explains depression, generalized anxiety, and death anxiety
Open accessAbstract
The adverse psychological effects of COVID-19 have increased globally. Moreover, the psychological toll may be worsening for this health crisis due to the growing numbers of mass deaths and unemployment levels. Coronaphobia, a relatively new pandemic-related construct, has been shown to be strongly related to functional impairment and psychological distress. However, the extent to which coronaphobia is uniquely accountable for the psychological distress experienced during the COVID-19 crisis has not been systematically investigated. The current study examined this question of incremental validity using online data from 453 adult MTurk workers in the U.S. The results of a series of hierarchical multiple regression analyses demonstrated that coronaphobia explained additional variance in depression, generalized anxiety, and death anxiety, above sociodemographics, COVID-19 factors, and the vulnerability factors of neuroticism, health anxiety, and reassurance-seeking behaviors. These findings suggest that health professionals should be aware of coronaphobia as this expression of pandemic-related stress has reliably demonstrated incremental validity in accounting for major indicators of psychological distress.
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Death anxiety is associated with mental disorders, such as panic, generalized anxiety, and depressive disorders.
“Death anxiety is thought to be associated with mental disorders, such as panic, generalized anxiety, and depressive disorders (Iverach et al., 2014; Lee et al., 2020).”
From Mediator role of presence of meaning and self-esteem in the relationship of social support and death anxiety (2022) · cites this paper as Lee et al., 2020
The Results (Descriptive statistics and zero-order correlations; page unavailable) say that death anxiety, depression, and generalized anxiety were among the study’s intercorrelated outcome variables. The paper does not address panic disorder, and its measures concern symptoms rather than diagnosed disorders. (LLM, conf=0.78)
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“Fourth, in our study we could not use a specific measure of COVID-19 psychological distress – as for example the recently developed Fear of COVID-19 Scale (Ahorsu et al., 2020), Coronavirus Anxiety Scale (lee et al., 2020a, 2020b), COVID Stress Scales (Taylor et al., 2020), and COVID-19 Anxiety Syndrome Scale (Nikčevi…”
MethodAn investigation of potential coronaphobia-related factors in adults and sleep quality relations
Karaaslan, Y., Mete, O., Karadağ, M., Kaya, D. Ö., & Celenay, S. T. (2021) · Sleep Medicine · doi:10.1016/j.sleep.2021.06.016 · Cited by 34 · see citing works
Padovan‐Neto, F. E., Lee, S. A., Guimarães, R. P., Godoy, L. D., Costa, H. B., Zerbini, F. L. S., & Fukusima, S. S. (2021) · OMEGA - Journal of Death and Dying · doi:10.1177/0030222821991325 · Cited by 33 · see citing works
Self-citationMehus, C. J., Lyden, G. R., Bonar, E. E., Gunlicks-Stoessel, M., Morrell, N., Parks, M. J., Wagner, A. C., & Patrick, M. E. (2023) · Journal of American College Health · doi:10.1080/07448481.2021.1942009 · Cited by 32 · see citing works
COVID-19 Pandemic and Death Anxiety in Security Forces in Spain
Lázaro-Pérez, C., López, J. Á. M., Galán, J. G., & Martínez, M. D. M. F. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17217760 · Cited by 32 · see citing works
Ahn, M. H., Lee, J., Suh, S. A., Lee, S., Kim, H. J., Shin, Y., & Chung, S. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.604441 · Cited by 32 · see citing works
Self-citationSahu, D. P., Pradhan, S. K., Sahoo, D. P., Patra, S., Singh, A. K., & Patro, B. K. (2021) · Asian Journal of Psychiatry · doi:10.1016/j.ajp.2020.102543 · Cited by 31 · see citing works
“A similar result was observed by Lee et al where no difference was observed for anxiety among individual under quarantine and without quarantine (Lee et al., 2020).”
ResultEnea, V., Candel, O., Zancu, S. A., Scrumeda, A., Bărbuşelu, M., Largu, A., & Manciuc, C. (2021) · Death Studies · doi:10.1080/07481187.2021.1928331 · Cited by 18 · see citing works
“…the scientific literature (Asmundson & Taylor, 2020), is defined as a dysfunctional physiologically based fear or anxiety reaction, expressing in highly somatic symptoms such as tonic immobility and faintness when the individual was exposed to information about the coronavirus (Lee et al., 2020).”
BackgroundResultFrom the Plague to the Coronavirus: Islamic Ethics and Responses to the COVID-19 Pandemic
Shabana, A. (2021) · Journal of Islamic Ethics · doi:10.1163/24685542-12340060 · Cited by 30 · see citing works
“The study points out the need for healthcare professionals to pay attention to this new phenomenon, due to the severe consequences that may result if it is otherwise overlooked or ignored (Lee et al. 2020).”
BackgroundOdero, S. A., Mwangi, P. M., Odhiambo, R., Nzioka, B. M., Shumba, C. S., Ndirangu, E. W., & Abubakar, A. A. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1123839 · Cited by 35 · see citing works
de Mello, A. J., Moretti, M., & Rodrigues, A. L. S. (2022) · World Journal of Psychiatry · doi:10.5498/wjp.v12.i7.874 · Cited by 31 · see citing works
Arpacıoğlu, S., Yalçın, M., Türkmenoğlu, F., Ünübol, B., & Çakıroğlu, O. Ç. (2021) · Psychogeriatrics · doi:10.1111/psyg.12762 · Cited by 31 · see citing works
Özekici, Y. K., & Küçükergi̇n, K. G. (2022) · Journal Of Vacation Marketing · doi:10.1177/13567667221109268 · Cited by 30 · see citing works
Martínez, S. A. H., Melchor-Martínez, E. M., González-González, R. B., Sosa-Hernández, J. E., Araújo, R., Rodríguez-Hernández, J. A., Barceló, D., Parra-Saldívar, R., & Iqbal, H. M. N. (2023) · Environmental Research · doi:10.1016/j.envres.2023.115892 · Cited by 23 · see citing works
Arslan, G. (2021) · Death Studies · doi:10.1080/07481187.2020.1871122 · Cited by 27 · see citing works
“Consistent with findings from this study, recent evidence suggests that people who exposed to coronavirus experiences reported greater death distress (L azaro-P erez et al., 2020; Lee et al., 2020; Menzies et al., 2020; Pradhan et al., 2020), as well as poor subjective wellbeing (Arslan, Allen, et al.”
BackgroundResultInfluentialCaycho‐Rodríguez, T., Tomás, J. M., Carbajal‐León, C., Vilca, L. W., Reyes-Bossio, M. A., Intimayta‐Escalante, C., Vivanco-Vidal, A., Saroli-Araníbar, D., Esteban, R. F. C., & White, M. (2021) · Trends in Psychology · doi:10.1007/s43076-021-00099-7 · Cited by 27 · see citing works
COVID-19 effect on mental health and sleep disorders
Samushiya, M. A., Kryzhanovsky, S. M., Ragimova, A. A., Berishvili, T. Z., Chorbinskaya, S. A., & Ivannikova, E. I. (2021) · S S Korsakov Journal of Neurology and Psychiatry · doi:10.17116/jnevro202112104249 · Cited by 27 · see citing works
Richter, L., & Heidinger, T. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.737787 · Cited by 25 · see citing works
Virtual Reality Exposure Therapy (VRET) for Anxiety Due to Fear of COVID-19 Infection: A Case Series
Zhang, W., Paudel, D., Shi, R., Liang, J., Liu, J., Zeng, X., Zhou, Y., & Zhang, B. (2020) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s276203 · Cited by 26 · see citing works
Ardestani, S. M. S., Khosravani, V., Bastan, F. S., & Балоглу, М. (2021) · International Journal of Mental Health and Addiction · doi:10.1007/s11469-021-00523-0 · Cited by 27 · see citing works
“…increase phobic reactions (Arpaci, Karatas, et al., 2020; Arpaci, Karataş, & Baloğlu, 2020), phobic anxiety (Fernández et al., 2020), and coronaphobia (Mora-Magaña et al., 2020; Toprak Celenay et al., 2020) that are thought to result in anxiety-related disorders or conditions (Lee et al., 2020).”
BackgroundFaustino, B., Vasco, A. B., Delgado, J., Farinha‐Fernandes, A., & Guerreiro, J. C. (2022) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2706 · Cited by 26 · see citing works
“…array of psychopathological symptoms, such as depression (Bueno-Notivol et al., 2021; Qiu et al., 2020), anxiety (Albery et al., 2021; Lee, 2020; Lee et al., 2020), depression and anxiety (Porter et al., 2021; Rondung et al., 2021; Woon et al., 2021), stress (Gasteiger et al., 2021; Varma et…”
BackgroundSchnell, T., & Krampe, H. (2022) · BMC Psychiatry · doi:10.1186/s12888-022-03921-3 · Cited by 33 · see citing works
“Besides an intensified confrontation with one’s mortality [21, 22], experiences of meaning – or its loss – are of crucial importance here.”
BackgroundCOVID-19 and Acute Myocardial Injury and Infarction: Related Mechanisms and Emerging Challenges
Manolis, A. S., Manolis, T. A., Manolis, T. A., & Melita, H. (2021) · Journal of Cardiovascular Pharmacology and Therapeutics · doi:10.1177/10742484211011026 · Cited by 24 · see citing works
Surżykiewicz, J., Konaszewski, K., Skalski‐Bednarz, S. B., Dobrakowski, P. P., & Muszyńska, J. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10214974 · Cited by 26 · see citing works
Caycho‐Rodríguez, T., Valencia, P. D., Vilca, L. W., Carbajal‐León, C., Vivanco-Vidal, A., Saroli-Araníbar, D., Reyes-Bossio, M. A., White, M., Rojas-Jara, C., Polanco-Carrasco, R., et al. (2022) · Current Psychology · doi:10.1007/s12144-021-02563-0 · Cited by 25 · see citing works
The Relationship between Personality Traits and COVID-19 Anxiety: A Mediating Model
Kumar, V. V., & Tankha, G. (2022) · Behavioral Sciences · doi:10.3390/bs12020024 · Cited by 23 · see citing works
“The current results are further corroborated by findings of the other previous research on general anxiety [8,17,21].”
BackgroundResultZhao, B.-Y., Chen, M., Lin, R., Yan, Y., & Li, H. (2024) · BMC Nursing · doi:10.1186/s12912-024-02275-3 · Cited by 22 · see citing works
Moreta‐Herrera, R., López-Calle, C., Caycho‐Rodríguez, T., Guerra, C. B. C., Gallegos, M., Cervigni, M., Martino, P., Barés, I., & Calandra, M. (2021) · Death Studies · doi:10.1080/07481187.2021.1914240 · Cited by 23 · see citing works
“These negative consequences could produce what some have called ’coronaphobia’ (Lee et al., 2020).”
BackgroundGlobal validation of the Coronavirus Anxiety Scale (CAS)
Lieven, T. (2021) · Current Psychology · doi:10.1007/s12144-021-02583-w · Cited by 23 · see citing works
Caycho‐Rodríguez, T., Tomás, J. M., Vilca, L. W., Cadena, C. H. G., Rojas-Jara, C., White, M., & Peña-Calero, B. N. (2021) · Psychology Health & Medicine · doi:10.1080/13548506.2021.1944655 · Cited by 23 · see citing works
“Likewise, people with anxiety about COVID-19 experience greater symptoms of depression, generalized anxiety, hopelessness and functional deficiencies, negatively affecting their well-being (Ahmed et al., 2020; Ahorsu et al., 2020; Lee, 2020; Lee et al., 2020a, 2020b).”
BackgroundA Systematic Review and Meta-Analysis on Death Anxiety During COVID-19 Pandemic
Patra, I., Muda, I., Ketut Acwin Dwijendra, N., Najm, M. A., Hamoud Alshahrani, S., Sajad Kadhim, S., Hameed, N. M., Alnassar, Y. S., Mohammed, N. M., Mustafa, Y. F., et al. (2025) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228221144791 · Cited by 23 · see citing works
“…et al., 2021 354 Turkey 56.9 June to Oct 2020 Elderly 68.3 ± 2.90 DAS Damirchi et al., 2020 354 Iran 64.7 Jan to Mar 2020 General population — DAS Lee et al., 2020 453 United States 53.25 Jan to Mar 2020 General population — Single item Kavaklı et al., 2020 562 Turkey 26.5 — General…”
BackgroundInfluentialCOVID-19 phobia in healthcare workers; a cross-sectional study from a pandemic hospital
Arslan, B. O., Batum, Ö., Varol, Y., Şenel, E., & Uçar, Z. Z. (2021) · Tuberkuloz ve Toraks · doi:10.5578/tt.20219810 · Cited by 24 · see citing works
“Research on coronaphobia has revealed that it is strongly associated with elevated depression, anxiety, hopelessness, and functional impairments (22).”
BackgroundInfluentialCaycho‐Rodríguez, T., Vilca, L. W., Peña-Calero, B. N., Barboza-Palomino, M., White, M., & Reyes-Bossio, M. A. (2021) · Revista Española de Geriatría y Gerontología · doi:10.1016/j.regg.2021.09.001 · Cited by 22 · see citing works
Díaz, M. S., Martín, M. L., & Mateos-Campos, R. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18115944 · Cited by 21 · see citing works
“These psychological effects have been observed in populations worldwide, such as the United States [27], Hong Kong [28], China [26,29] and Japan [30].”
BackgroundHajek, A., & König, H. (2022) · Death Studies · doi:10.1080/07481187.2022.2059722 · Cited by 21 · see citing works
“Moreover, a cutoff of 9 was suggested for psychiatric screening (Lee et al., 2020).”
BackgroundDepression as a mediator between fear of COVID-19 and death anxiety
Gündoğan, S., & Arpacı, İ. (2022) · Current Psychology · doi:10.1007/s12144-022-03120-z · Cited by 21 · see citing works
“Previous studies have concluded that FoC is an important predictor of death anxiety (Habiboğlu et al., 2021; Lee et al., 2020).”
Institutional Trust as a Protective Factor during the COVID-19 Pandemic in China
Li, S., Sun, Y., Jing, J., & Wang, E. (2022) · Behavioral Sciences · doi:10.3390/bs12080252 · Cited by 21 · see citing works
Maita, I., Roepke, T. A., & Samuels, B. A. (2022) · Frontiers in Behavioral Neuroscience · doi:10.3389/fnbeh.2022.903782 · Cited by 21 · see citing works
The COVID-19 global pandemic: a review of the Vietnamese Government response
Tran, L. N., Manuama, E. O., Vo, N. D. P., Huy, N. V., Cassim, R., Pham, M. D., & Bui, D. (2021) · Journal of Global Health Reports · doi:10.29392/001c.21951 · Cited by 20 · see citing works
Exploring the Therapeutic Potential of Terpenoids for Depression and Anxiety
Noor, A. A. M. (2024) · Chemistry & Biodiversity · doi:10.1002/cbdv.202400788 · Cited by 19 · see citing works
Helbich, M., & Jabr, S. (2021) · International Journal of Human Rights in Healthcare · doi:10.1108/ijhrh-06-2020-0039 · Cited by 19 · see citing works
Su, X., Cai, R. Y., Uljarević, M., Herwegen, J. V., Dukes, D., Yang, Y., Peng, X., & Samson, A. C. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.708465 · Cited by 19 · see citing works
Trần, V. Đ. (2022) · Higher Education Pedagogies · doi:10.1080/23752696.2022.2113112 · Cited by 22 · see citing works
“In particular, teachers and students encountered a variety of technology issues, such as late check-in, lost connections, low-quality sound, and so on, all of which had a detrimental influence on student engagement and teaching quality (Lee, Jobe, Mathis, & Gibbons, 2020).”
BackgroundKoinig, I. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19031608 · Cited by 20 · see citing works
The Relationship Between Death Anxiety and COVID-19 Fear and Anxiety in Women With Breast Cancer
Kıyak, S., & Polat, H. T. (2022) · OMEGA - Journal of Death and Dying · doi:10.1177/00302228221086056 · Cited by 18 · see citing works
“In their study conducted in the USA, Lee et al. (2020) included 453 adults and reported that COVID-19-related anxiety led to an increase in death anxiety.”
Leite, Â. M. T., Vidal, D. G., Sousa, H. F. P. E., Dinis, M. A. P., & Magano, J. (2021) · European Journal of Investigation in Health Psychology and Education · doi:10.3390/ejihpe11030078 · Cited by 17 · see citing works
“[27] found that coronaphobia explained additional variance in depression, generalized anxiety, and death anxiety, above sociodemographics, COVID-19 factors, and the vulnerability factors of neuroticism, health anxiety, and reassurance-seeking behaviors.”
BackgroundSiegel, A., Mor, I., & Lahav, Y. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.1968597 · Cited by 16 · see citing works
Korkut, S. (2022) · Therapeutic Apheresis and Dialysis · doi:10.1111/1744-9987.13905 · Cited by 17 · see citing works
“Although studies have been conducted on coronavirus anxiety in the general population [44] and healthcare professionals [45], no studies have been found in patients withHD.”
BackgroundYüksel-Şahin, F. (2020) · IBAD Sosyal Bilimler Dergisi · doi:10.21733/ibad.799721 · Cited by 18 · see citing works
- Authors
- Lee, S. A., Jobe, M. C., Mathis, A. A., & Gibbons, J. A.
- Affiliations
- Christopher Newport University (US)
- Corresponding author
- Lee, Sherman A.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2020-08
- Volume
- 74
- Pages
- 102268
- ISSN
- 0887-6185 (ISSN-L)
- PMC
- PMC7328548
- OpenAlex
- W3039080593
- Cited by
- 392
- References
- 23
- Citations by year
- 2026: 13 · 2025: 30 · 2024: 35 · 2023: 92 · 2022: 82 · 2021: 107 · 2020: 32 · 2019: 1
- FWCI
- 31.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Anxiety Disorders (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Communication › Communication and COVID-19 Impact
- Keywords
- fear of COVID-19, COVID-19 pandemic, incremental validity, depression, generalized anxiety disorder, fear of death, psychological distress, pandemic stress, health anxiety, reassurance seeking, neuroticism, healthcare workers
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Anxiety, Depression, Disease Outbreaks, Fear, Humans, Pneumonia, Viral, Stress, Psychological, Coronavirus, Coronavirus Infections, Pandemics
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