The prospective influence of COVID-19 affective risk assessments and intolerance of uncertainty on later dimensions of health anxiety
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The COVID-19 pandemic is likely to increase risk for the development of health anxiety. Given that elevated health anxiety can contribute to maladaptive health behaviors, there is a need to identify individual difference factors that may increase health anxiety risk. This study examined the unique and interactive relations of COVID-19 affective risk assessments (worry about risk for contracting/dying from COVID-19) and intolerance of uncertainty to later health anxiety dimensions. A U.S. community sample of 364 participants completed online self-report measures at a baseline assessment (Time 1) and one month later (Time 2). Time 1 intolerance of uncertainty was uniquely associated with the Time 2 health anxiety dimension of body vigilance. Time 1 affective risk assessments and intolerance of uncertainty were uniquely associated with later perceived likelihood that an illness would be acquired and anticipated negative consequences of an illness. The latter finding was qualified by a significant interaction, such that affective risk assessments were positively associated with anticipated negative consequences of having an illness only among participants with mean and low levels of intolerance of uncertainty. Results speak to the relevance of different risk factors for health anxiety during the COVID-19 pandemic and highlight targets for reducing health anxiety risk.
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Tull et al. (2020) found that intolerance of uncertainty only moderated the association between COVID-19 affective risk assessments and health anxiety at low and mean levels, with no significant association at high levels.
“Tull et al. found that IU only moderated the association between COVID-19 affective risk assessments and health anxiety at low and mean levels — there was no significant association at high levels of IU.”
From Anxiety Sensitivity Mediates Relations Between Mental Distress Symptoms and Medical Care Utilization During COVID-19 Pandemic. (2021) · cites this paper as Tull et al.’s (2020)
The Results (Primary analyses) report a significant association between COVID-19 affective risk and later illness severity at low and mean levels of intolerance of uncertainty, but not at high levels. The Discussion says intolerance of uncertainty did not moderate the associations with the other two health-anxiety dimensions, illness likelihood and body vigilance. The claim is therefore accurate for illness severity but overgeneralizes the finding to health anxiety as a whole. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIntolerance of uncertainty biases information processing, leading to faulty appraisals of threat, and reduces coping abilities.
“It is a cognitive, emotional, and behavioral tendency to react negatively to uncertain or ambiguous situations and unpredictable future events [57,58], which biases information processing, leading to faulty appraisals of threat, and reduces coping abilities [59].”
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- Authors
- Tull, M. T., Barbano, A. C., Scamaldo, K. M., Richmond, J. R., Edmonds, K. A., Rose, J. P., & Gratz, K. L.
- Affiliations
- University of Toledo (US)
- Corresponding author
- Tull, Matthew T.
- Venue
- Journal of Anxiety Disorders
- Publisher
- Elsevier BV
- Published
- 2020-10
- Volume
- 75
- Pages
- 102290
- ISSN
- 0887-6185 (ISSN-L)
- PMC
- PMC7422821
- OpenAlex
- W3048683406
- Cited by
- 98
- References
- 71
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 22 · 2023: 14 · 2022: 28 · 2021: 27 · 2020: 2
- FWCI
- 7.09
- 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
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Keywords
- health anxiety, COVID-19 pandemic, intolerance of uncertainty, body vigilance, individual differences, mental health during pandemic
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adult, Aged, Anxiety, Female, Humans, Male, Middle Aged, Pneumonia, Viral, Prospective Studies, Health Behavior, Coronavirus Infections, Risk Assessment, Uncertainty, Young Adult, Self Report, Pandemics
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