Behind the masks: A cross-sectional study on intolerance of uncertainty, perceived vulnerability to disease and psychological flexibility in relation to state anxiety and wellbeing during the COVID-19 pandemic

Probably not a substantial claim: may not pass S3 (load-bearing).

During the pandemic, psychological flexibility moderated the relationship between COVID-19 stressors and suicide risk.

“During the pandemic PF has also been found to moderate the relationships between social isolation and depression and anxiety (Smith et al., 2020), COVID-19 risk factors and mental health difficulties (Pakenham et al., 2020), COVID-19 stressors and suicide risk (Crasta et al., 2020) and psychological distress within family systems (Daks et al., 2020).”

• cites Crasta et al., 2020 sourceDisputed

  The Results section (‘Moderation of mediation path by psychological inflexibility’) says psychological flexibility did not emerge as a significant moderator after accounting for inflexibility. It was psychological inflexibility that moderated the indirect association between COVID-19 stressors and desire for death through perceived burdensomeness. No page number is available in our copy. (LLM, conf=0.90)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Smith et al. conceptualised intolerance of uncertainty as a specific manifestation of psychological flexibility.

“Smith et al. (2020) conceptualised IU as a specific manifestation of PF (difficulty accepting thoughts and feelings related to uncertainty and a behavioral orientation towards emotional control).”

• cites Smith et al. (2020) sourceDisputed

  The passage labeled Abstract conceptualizes intolerance of uncertainty as a specific instance of psychological *inflexibility*, not flexibility. It associates difficulty accepting uncertainty-related thoughts and feelings with intolerance of uncertainty, but assigns rigid emotional control to emotional suppression. (LLM, conf=0.88)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Social support is positively associated with mental wellbeing during pandemics.

“Conversely, social support is positively associated with mental wellbeing during pandemics (Ko et al., 2006; Xiao et al., 2020).”

• cites Ko et al., 2006Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Xiao et al., 2020 sourcePartly supported

  The Discussion (page unavailable) says social support reduces negative emotions and suggests that mutual support may reduce anxiety among people isolated during epidemics. However, the study measured social capital, which the Background distinguishes from social support; it does not establish a general association between social support and mental wellbeing during pandemics. (LLM, conf=0.83)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

COVID-19 symptoms and disease exposure are associated with negative psychological outcomes including depression, anxiety, and stress.

“Factors relating to COVID-19 symptoms and disease exposure are associated with negative psychological outcomes including depression, anxiety and stress (Moghanibashi-Mansourieh, 2020; Wang et al., 2020).”

• cites Moghanibashi-Mansourieh, 2020 sourcePartly supported

  The Results report higher anxiety among people living in high-prevalence areas and those with a family member, relative, or friend with COVID-19. The paper does not report an association between COVID-19 symptoms or disease exposure and depression or stress; its Discussion mentions depression and stress when describing Wang et al. (2020). Page numbers are unavailable in our copy. (LLM, conf=0.87)

  Experimental — accuracy not yet measured
• cites Wang et al., 2020 sourceSupported

Classified as probably not a substantial claim.

The COVID-19 pandemic, through combined health risk, mass disruption, and isolation, has the potential to cause substantial negative mental health outcomes.

“The combined health-risk, mass disruption and isolation caused by the COVID-19 pandemic has the potential for substantial negative mental health outcomes (Holmes et al., 2020; Kelly, 2020; Mucci et al., 2020).”

• cites Holmes et al., 2020 sourceSupported
• cites Kelly, 2020 sourceSupported
• cites Mucci et al., 2020 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Cross-sectional studies have reported associations between the COVID-19 pandemic and negative psychological outcomes such as anxiety, distress, depression, and post-traumatic stress.

“Cross-sectional studies have reported associations between the COVID-19 pandemic and negative psychological outcomes including anxiety, distress, depression, and post-traumatic stress (Moghanibashi-Mansourieh, 2020; Rossi et al., 2020; Shevlin et al., 2020; Wang et al., 2020).”

• cites Moghanibashi-Mansourieh, 2020 sourcePartly supported

  The Results and Discussion report an association between COVID-19 exposure or prevalence and anxiety in the Iranian survey. The Discussion also recounts another study’s findings on distress and depression, but this paper does not report post-traumatic stress as an outcome. It therefore supports only part of the outcome list attributed to it. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites Rossi et al., 2020 sourceSupported
• cites Shevlin et al., 2020 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The 2002-2003 SARS outbreak had a lasting negative mental health impact on survivors, including elevated stress and psychological distress one year later and depression and sleep disruption over 18 months after infection.

“A comparable event, the Severe Acute Respiratory Syndrome (SARS) outbreak of 2002–2003, had a lasting negative impact on the mental health of survivors, with elevated stress levels and psychological distress found one year after the outbreak (Lee et al., 2007) and depression and sleep disruption over 18 months post-infection (Moldofsky & Patcai, 2011).”

• cites Lee et al., 2007 sourceNot checked — no full text of the source
• cites Moldofsky & Patcai, 2011 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Pandemic-related impact events, including trauma experienced by keyworkers, loss of income, and bereavement or inability to care for an unwell or dying loved one, affect mental wellbeing.

“Additionally, pandemic-related experiences or ‘impact events’ impact mental wellbeing including trauma experienced by keyworkers (Lee et al., 2007; Wu et al., 2009), loss of income (Shevlin et al., 2020), and being bereaved or unable to care for a loved one who is unwell or dying (Vigo et al., 2020).”

• cites Lee et al., 2007 sourceNot checked — no full text of the source
• cites Wu et al., 2009Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Shevlin et al., 2020 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Feeling well-informed about the COVID-19 pandemic is associated with lower anxiety.

“Whereas, feeling well-informed about the COVID-19 pandemic is associated with lower anxiety (Jungmann & Witthöft, 2020).”

• cites Jungmann & Witthöft, 2020 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Disruption to daily routine and future plans is associated with lower mental wellbeing in previous health crises and during the COVID-19 pandemic.

“Disruption to daily routine and future plans were associated with lower mental wellbeing in previous health crises (Jeong et al., 2016; Mak et al., 2009; Mihashi et al., 2009) and during the COVID-19 pandemic (Williams et al., 2020).”

• cites Jeong et al., 2016 sourcePartly supported

  The Introduction says hospital and school closures increased anxiety during the MERS outbreak, and the Results associate inadequate supplies during isolation with later anxiety and anger. These support a link between some disruptions to daily life and poorer mental health, but the paper does not establish an association involving disrupted future plans. The COVID-19 portion of the citing sentence is attributed to a different source. (LLM, conf=0.82)

  Experimental — accuracy not yet measured
• cites Mak et al., 2009 sourcePartly supported

  The Discussion (Range of psychiatric disorders and functional outcome; page unavailable) reports poorer quality of life among SARS survivors and suggests that functional impairment and unemployment may have complicated their psychiatric difficulties. It does not establish an association between disruption to daily routine or future plans and lower mental wellbeing. The COVID-19 portion of the sentence is attributed to a different citation, not Mak et al. (LLM, conf=0.75)

  Experimental — accuracy not yet measured
• cites Mihashi et al., 2009 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Longitudinal studies with pre-pandemic and during-pandemic data show decreases in wellbeing and increases in anxiety, mental distress, and psychopathological symptoms.

“These findings are supported by longitudinal studies with pre- and during pandemic data showing decreases in wellbeing and increases in anxiety, mental distress and psychopathological symptoms (Kwong et al., 2020; Schäfer et al., 2020; Twenge & Joiner, 2020).”

• cites Kwong et al., 2020Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Schäfer et al., 2020 sourcePartly supported

  The Pre-to Post-Outbreak Change Using BLCS section (page unavailable) reports increased psychopathological symptoms in the high-stress group, supporting that part of the longitudinal claim. It also reports no overall increase and decreased symptoms in the low-stress group. The paper does not report pre-to-during-pandemic decreases in wellbeing or increases in anxiety or mental distress as separate outcomes. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites Twenge & Joiner, 2020 sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

Psychological flexibility is associated with greater wellbeing during the pandemic and protects against negative psychological impacts of the COVID-19 situation.

“However, a number of studies have found psychological flexibility to be associated with greater wellbeing during the pandemic and to be protective against the negative psychological impacts of the COVID-19 situation (e.g. Chong et al., 2021; Gloster, Lamnisos et al., 2020; McCracken et al., 2021).”

• cites Chong et al., 2021 sourceSupported
• cites Gloster, Lamnisos et al., 2020 sourceSupported
• cites McCracken et al., 2021 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Social isolation and self-quarantine are associated with psychological distress.

“Social isolation and self-quarantine have been associated with psychological distress (Boyraz et al., 2020; Brooks, 2020; Smith et al., 2020).”

• cites Boyraz et al., 2020 sourcePartly supported

  The Introduction describes social isolation as a source of stress, anxiety and depressive symptoms, and the Discussion links greater social isolation to vulnerability to COVID-19-related traumatic stress. The Introduction also lists quarantine among containment measures that brought challenges and stressors, but it does not establish a distinct association between self-quarantine and psychological distress. (LLM, conf=0.82)

  Experimental — accuracy not yet measured
• cites Brooks, 2020 sourceSupported
• cites Smith et al., 2020 sourcePartly supported

  The Abstract and Discussion report an association between social isolation and psychological distress during COVID-19. The paper discusses quarantine periods and stay-at-home orders, but the passages do not establish a separate association between self-quarantine and distress. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The SWEMWBS has demonstrated good to excellent internal validity (α = 0.84).

“Internal validity of the SWEMWBS has been demonstrated as good to excellent (α = 0.84; Fat et al., 2017).”

• cites Fat et al., 2017 sourcePartly supported

  The Criterion validity section reports a Cronbach’s alpha of 0.84 for SWEMWBS, above the paper’s stated threshold for acceptable internal reliability. The cited result concerns internal consistency or reliability, not internal validity as the citing sentence says. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Chong et al. found that psychological flexibility and prosociality mediated the relationship between illness perceptions toward COVID-19 and mental health, with psychological flexibility also directly affecting prosociality.

“Chong et al. (2021) found PF and prosociality mediated the relationship between illness perceptions toward COVID-19 and mental health with PF additionally exerting a direct effect on prosociality.”

• cites Chong et al. (2021) sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

During the pandemic, psychological flexibility moderated the relationship between social isolation and depression and anxiety.

“During the pandemic PF has also been found to moderate the relationships between social isolation and depression and anxiety (Smith et al., 2020), COVID-19 risk factors and mental health difficulties (Pakenham et al., 2020), COVID-19 stressors and suicide risk (Crasta et al., 2020) and psychological distress within family systems (Daks et al., 2020).”

• cites Smith et al., 2020 sourceSupported

Classified as probably not a substantial claim. May combine two claims.

A large body of research supports an association between psychological flexibility and mental wellbeing, and between psychological inflexibility and depression and anxiety.

“A large body of research supports the association of PF with mental wellbeing, and the association of psychological inflexibility with psychological difficulties including depression and anxiety (Doorley et al., 2020; Kashdan & Rottenberg, 2010).”

• cites Doorley et al., 2020 sourceNot checked — no full text of the source
• cites Kashdan & Rottenberg, 2010 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The IUS-12 has excellent internal consistency for the full scale (α = 0.93) and good internal consistency for prospective IU (α = 0.89) and inhibitory IU (α = 0.89).

“The IUS-12 has been found to have excellent internal consistency of α = 0.93 for the full scale and good internal consistency for subscale scores α = 0.89 (prospective IU) and α = 0.89 (inhibitory IU) (Carleton et al., 2013).”

• cites Carleton et al., 2013 sourcePartly supported

  The IUS-12 section reports internal consistency in the current sample of α = .93 for the total score and α = .89 for prospective IU. It reports α = .88, not .89, for inhibitory IU; the figures also describe this study’s sample rather than the scale universally. (LLM, conf=0.94)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The relationship between perceived vulnerability to disease and traumatic stress is mediated by COVID-19 worries and social isolation.

“During the COVID-19 pandemic research has found associations between PVD and general anxiety (Makhanova & Shepherd, 2020) and a relationship between PVD and traumatic stress was mediated by COVID-19 worries and social isolation (Boyraz et al., 2020).”

• cites Boyraz et al., 2020 sourceSupported

Classified as probably not a substantial claim.

During the pandemic, psychological flexibility moderated the relationship between COVID-19 risk factors and mental health difficulties.

“During the pandemic PF has also been found to moderate the relationships between social isolation and depression and anxiety (Smith et al., 2020), COVID-19 risk factors and mental health difficulties (Pakenham et al., 2020), COVID-19 stressors and suicide risk (Crasta et al., 2020) and psychological distress within family systems (Daks et al., 2020).”

• cites Pakenham et al., 2020 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

During the pandemic, psychological flexibility moderated psychological distress within family systems.

“During the pandemic PF has also been found to moderate the relationships between social isolation and depression and anxiety (Smith et al., 2020), COVID-19 risk factors and mental health difficulties (Pakenham et al., 2020), COVID-19 stressors and suicide risk (Crasta et al., 2020) and psychological distress within family systems (Daks et al., 2020).”

• cites Daks et al., 2020 sourcePartly supported

  The Results (Correlations among study variables; page unavailable) link parental psychological flexibility with parent depressive symptoms, while the Discussion (Implications; page unavailable) describes an indirect path from flexibility through lower family discord to lower child distress. The paper reports associations and path analyses, not a finding that flexibility moderated a relationship involving psychological distress. (LLM, conf=0.84)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim. May combine two claims.

During the pandemic, psychological flexibility predicted wellbeing, stress, depression, and affect.

“Supporting this, PF was found to predict wellbeing, stress, depression and affect during the pandemic (Dawson & Golijani-Moghaddam, 2020; Gloster, Lamnisos et al., 2020).”

• cites Dawson & Golijani-Moghaddam, 2020 sourcePartly supported

  The Results (Regression analyses; page unavailable) report that psychological flexibility predicted wellbeing and distress outcomes during the pandemic, including depression and COVID-19-specific distress. The paper does not identify affect or a separate stress measure among those outcomes, so the full list attributed to it is not supported. (LLM, conf=0.84)

  Experimental — accuracy not yet measured
• cites Gloster, Lamnisos et al., 2020 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The CompACT has excellent internal consistency for all items (α = 0.91), and good to excellent internal consistency for openness to experience (α = .90), behavioral awareness (α = 0.87), and valued action (α = 0.90).

“The CompACT has demonstrated excellent internal consistency for all items α = 0.91, and good to excellent internal consistency for each of the subscales, openness to experience α = .90; behavioral awareness α = 0.87; and valued action α = 0.90 (Francis et al., 2016).”

• cites Francis et al., 2016 sourcePartly supported

  Table 4 (p. 72) reports high internal consistency for the three CompACT factors, with Cronbach’s α of .91, .91, and .87. The cited sentence matches the .87 value for the awareness factor, but gives .90 rather than .91 for the other two and uses different subscale names. Section 3.5 (pp. 73–74) reports an average item-total correlation of .31 for the full measure, not the claimed total-scale α of .91. (LLM, conf=0.89)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

A web-based self-help programme for college students had positive outcomes on a range of psychological difficulties and positive mental health.

“and a web-based self-help programme for college students was found to have positive outcomes on a range of psychological difficulties and positive mental health (Levin, Haeger, et al., 2017).”

• cites Levin, Haeger, et al., 2017 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

ACT workshops for staff in a special education setting influenced factors affecting depression, stress, and burnout.

“For example, ACT workshops for staff in a special education setting were found to influence factors affecting depression, stress, and burnout (Biglan et al., 2013)”

• cites Biglan et al., 2013 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Other studies found higher anxiety in younger age groups during the pandemic.

“Other studies have also found higher anxiety in younger age groups during the pandemic (Fancourt et al., 2020; Rossi et al., 2020).”

• cites Fancourt et al., 2020Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Rossi et al., 2020 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

The health threat from COVID-19 increases with age.

“given the health threat from COVID-19 increases with age (Docherty et al., 2020)”

• cites Docherty et al., 2020 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Older people experience better emotion regulation than younger adults.

“that show older people experience better emotion regulation than younger adults (e.g. Carstensen et al., 2011).”

• cites Carstensen et al., 2011 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

An RCT of ACT versus CBT for GAD found that intolerance of uncertainty improved in both conditions, with the ACT group performing slightly better.

“Furthermore, an RCT of ACT versus CBT for GAD found that IU improved in both conditions, with the ACT group performing slightly better (Avdagic et al., 2014).”

• cites Avdagic et al., 2014 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Previous studies found a similar magnitude of correlation between psychological flexibility and intolerance of uncertainty as reported in this study.

“Previous studies have found a similar magnitude of correlation between PF and IU as reported in this study (r = 0.55 - 0.65, Smith et al., 2020; Stevens et al., 2018).”

• cites Smith et al., 2020 sourceSupported
• cites Stevens et al., 2018 sourceNot checked — no full text of the source

May combine two claims.

Adding CompACT, PVDQ and IUS-12 in Step 3 significantly improved the state anxiety model, with the final model accounting for 48.7% of variance and an additional 11.6%.

“After entry of the CompACT, PVDQ and IUS-12 measures in Step 3, the final model accounted for 48.7% of the variance in state anxiety, significantly improving the model and accounting for an additional 11.6% of the variance.”

May combine two claims.

Adding CompACT, PVDQ and IUS-12 in Step 3 significantly improved the wellbeing model, with the final model accounting for 46.5% of variance and an additional 7%.

“After entry of CompACT, PVDQ and IUS-12 measures in Step 3, the final model accounted for 46.5% of the variance, significantly improving the model and accounting for an additional 7% of the variance in mental wellbeing.”

May combine two claims.

Adding COVID-19 contextual factors in Step 2 significantly improved the state anxiety model and accounted for an additional 19.6% of variance.

“The addition of COVID-19 contextual factors in Step 2 significantly improved the model, accounting for an additional 19.6% of the variance.”

May combine two claims.

The overall magnitude of the contextual correlations was relatively weak, except for good social support and increased loneliness.

“However, the overall magnitude of these correlations was relatively weak, with the exception of good social support and increased loneliness.”

May combine two claims.

Adding COVID-19 contextual factors in Step 2 significantly improved the wellbeing model and accounted for an additional 28% of variance.

“The addition of the COVID-19 contextual factors in Step 2 significantly improved the model, accounting for an additional 28% of the variance.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Age had a small positive correlation with mental wellbeing.

“and a small positive correlation with mental wellbeing (r = 0.26, p < .001)”

May combine two claims.

Cognitive appraisals were significantly associated with state anxiety and to some extent mental wellbeing.

“Cognitive appraisals were found to be significantly associated with state anxiety and to some extent mental wellbeing.”

May combine two claims.

The moderation of the mediation effects by psychological flexibility was significant but relatively weak.

“The moderation of those effects by PF was significant, but was a relatively weak effect.”

May combine two claims.

The same pattern of moderated mediation occurred for wellbeing, though the direct path from perceived vulnerability to disease to wellbeing was not significant.

“Panel B shows the same pattern of moderated mediation for the outcome of wellbeing, though the direct path from PVD to wellbeing was not significant in this model.”

May combine two claims.

The conditional process models supported the hypotheses that the impact of perceived vulnerability to disease on state anxiety and wellbeing is mediated by intolerance of uncertainty and buffered at high psychological flexibility.

“The conditional process models supported the hypotheses that the impact of PVD on state anxiety and wellbeing would be mediated by IU, and that this would be buffered at high levels of PF.”

May combine two claims.

Biased cognitive appraisals of uncertainty predicted both anxiety and wellbeing, whereas biased appraisals relating to threat of infection predicted only state anxiety.

“Biased cognitive appraisals of uncertainty predicted both anxiety and wellbeing, whereas biased cognitive appraisals relating to the threat of infection predicted only state anxiety.”

May combine two claims.

Cognitive theories of emotions, stress, and coping suggest that contextual factors alone do not account for the pandemic's impact on mental wellbeing; individual differences in cognitive appraisals also influence it.

“Cognitive theories of emotions, stress and coping (Clark & Beck, 2010; Smith & Lazarus, 1993), suggest that contextual factors alone will not account for the impact of the pandemic on mental wellbeing, individual differences in cognitive appraisals will also have an influence.”

• cites Clark & Beck, 2010Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Smith & Lazarus, 1993 sourceNot checked — no full text of the source

May combine two claims.

In the context of COVID-19, intolerance of uncertainty positively correlates with depression, anxiety, and stress.

“In the context of COVID-19, IU has been found to moderate the relationships between social isolation and anxiety and mental wellbeing (Smith et al., 2020), to positively correlate with depression, anxiety and stress (Seco Ferreira et al., 2020), and to have both direct and mediated relationships with anxiety and wellbeing (Rettie & Daniels, 2020; Satici et al., 2020).”

• cites Seco Ferreira et al., 2020 sourceNot checked — no full text of the source

• AssumptionRests on an assumption: The COVID-19 pandemic has produced multiple stressors and a high degree of uncertainty.

May combine two claims.

The regression assumptions of normality, linearity, multicollinearity and homoscedasticity were met.

“All assumptions of normality, linearity, multicollinearity and homoscedasticity were met.”

Classified as probably not a substantial claim.

In the context of COVID-19, intolerance of uncertainty has both direct and mediated relationships with anxiety and wellbeing.

“In the context of COVID-19, IU has been found to moderate the relationships between social isolation and anxiety and mental wellbeing (Smith et al., 2020), to positively correlate with depression, anxiety and stress (Seco Ferreira et al., 2020), and to have both direct and mediated relationships with anxiety and wellbeing (Rettie & Daniels, 2020; Satici et al., 2020).”

• cites Rettie & Daniels, 2020Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Satici et al., 2020Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• AssumptionRests on an assumption: The COVID-19 pandemic has produced multiple stressors and a high degree of uncertainty.

Classified as probably not a substantial claim.

In an H1N1 influenza outbreak, higher perceived vulnerability to disease was associated with anxiety.

“In the context of an H1N1 influenza outbreak, Wheaton et al. (2012) found that higher PVD, was associated with anxiety.”

• cites Wheaton et al. (2012) sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

In the present sample, the SWEMWBS had α = 0.84.

“For this sample the SWEMWBS had α = 0.84.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In the present sample, the IUS-12 total score had α = 0.92, with subscale α = 0.86 for prospective IU and α = 0.88 for inhibitory IU.

“For this sample the full scale had α = 0.92 and subscale scores α = 0.86 (prospective IU) and α = 0.88 (inhibitory IU).”

Probably not a substantial claim: may not pass S3 (load-bearing).

One participant was excluded for selecting the lowest response to every item, suggestive of non-attentive responding.

“One participant was excluded for selecting the lowest response to every item, suggestive of a non-attentive responder.”

Probably not a substantial claim: may not pass S3 (load-bearing).

A review including 20 meta-analyses, 133 studies, and 12,477 participants found Acceptance and Commitment Therapy efficacious for all conditions examined, including anxiety.

“Further, a review including 20 meta-analyses, 133 studies, and 12,477 participants found ACT to be efficacious for all conditions examined, including anxiety (Gloster et al., 2020).”

• cites Gloster et al., 2020Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

Psychological flexibility has a protective moderating effect on psychological outcomes of daily stressors and threatening life events.

“A meta-analysis of 63 studies found significant relationships between psychological inflexibility and anxiety (Bluett et al., 2014) and a protective moderating effect of PF has been found for psychological outcomes of daily stressors and threatening life events (Gloster et al., 2017).”

• cites Gloster et al., 2017 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

A minimum of 258 participants was required, based on Green's (1991) guide, an expected medium effect size, 26 predictor variables, power of .80, and α = .05.

“Using Green's (1991) guide to estimating required sample sizes for regression analysis, an expected medium effect size, 26 predictor variables and a power of .80 (α = .05) a minimum of 258 participants were required.”

• cites Green's (1991) sourceNot checked — no full text of the source

May combine two claims.

Missing data for five participants were classed as missing completely at random by Little's MCAR test, and excluding these cases was not seen to introduce bias.

“Missing data for five participants was classed as missing completely at random (MCAR) using Little's MCAR test (χ2 = 109.608, df = 89, p = .068). Being MCAR and less than 1% of the sample from a large data set, exclusion of these cases was not seen to introduce bias (Tabachnick & Fidell, 2014).”

• cites Tabachnick & Fidell, 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In the present sample, the PVDQ total score had α = 0.80, with subscale α = 0.81 for Perceived Infectability and α = 0.88 for Germ Aversion.

“For this sample, all items had α = 0.80 and the subscales had α = 0.81 (Perceived Infectability) and α = 0.88 (Germ Aversion).”

Probably not a substantial claim: may not pass S3 (load-bearing).

A meta-analysis of 63 studies found significant relationships between psychological inflexibility and anxiety.

“A meta-analysis of 63 studies found significant relationships between psychological inflexibility and anxiety (Bluett et al., 2014) and a protective moderating effect of PF has been found for psychological outcomes of daily stressors and threatening life events (Gloster et al., 2017).”

• cites Bluett et al., 2014 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In the present sample, the CompACT total score had α = 0.89, with subscale α = 0.82 for openness to experience, α = 0.82 for behavioral awareness, and α = 0.88 for valued action.

“For this sample, all items had α = 0.89 and the subscales had α = 0.82 (openness to experience), α = 0.82 (behavioral awareness) and α = 0.88 (valued action).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The PVDQ has good internal consistency for all items (α = 0.82), α = 0.87 for Perceived Infectability, and adequate internal consistency for Germ Aversion (α = 0.74).

“The PVDQ has demonstrated good internal consistency α = 0.82 for all items and the subscale Perceived Infectability subscale (α = 0.87), and adequate internal consistency for the Germ Aversion subscale (α = 0.74) (Duncan et al., 2009).”

• cites Duncan et al., 2009 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

A review of 66 component studies found significant positive effect sizes for psychological flexibility treatment elements and positive outcomes, with larger effect sizes for theoretically specified outcomes.

“Addressing mechanisms for change in ACT, a review of 66 component studies found significant positive effect sizes for PF treatment elements and positive outcomes, with larger effect sizes for theoretically specified outcomes (Levin et al., 2012).”

• cites Levin et al., 2012 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

In the present sample, the CALM had α = 0.96.

“For this sample CALM showed excellent internal reliability with α = 0.96.”

May combine two claims.

The CALM showed strong concurrent validity with the state dimension of the State-Trait Anxiety Inventory (r = 0.90, p = .001), indicating it can accurately measure state anxiety.

“The CALM has strong concurrent validity (r = 0.90, p = .001) with the state dimension of the validated State-Trait Anxiety Inventory (STAI; Spielberger et al., 1983), suggesting CALM can accurately measure state anxiety.”

• cites Spielberger et al., 1983Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

Psychological flexibility processes such as cognitive defusion and acceptance are applied to coping with threat-related thoughts.

“Arch and Craske (2008) describe how PF processes (cognitive defusion, acceptance) are applied to coping with threat-related thoughts.”

• cites Arch and Craske (2008) sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing). May combine two claims.

The findings remain tentative and need replication in a more randomly selected sample.

“Therefore, the findings remain tentative and need replication in a more randomly selected sample.”

May combine two claims.

Intolerance of uncertainty has broader psychological implications than perceived vulnerability to disease because PVD predicted only state anxiety while IU predicted both anxiety and wellbeing.

“That PVD predicted only state anxiety, and IU predicted both anxiety and wellbeing suggests IU has broader psychological implications than PVD.”

Probably not a substantial claim: may not pass S3 (load-bearing).

These features drive rigid rule following and control-oriented behaviors characteristic of psychological inflexibility.

“These features drive rigid rule following and behaviors oriented at control, characteristic of psychological inflexibility.”

Probably not a substantial claim: may not pass S3 (load-bearing).

ACT training for people with mild-to-moderate depression and anxiety in a non-clinical sample had positive outcomes for mental health and wellbeing.

“Further, ACT training for people with mild-to-moderate depression and anxiety in a non-clinical sample had positive outcomes for mental health and wellbeing (Fledderus et al., 2012, 2013).”

• cites Fledderus et al., 2012, 2013Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The threat of rapid societal change during the pandemic has led to higher anxiety in younger people, who may feel more vulnerable due to less housing and financial security.

“Kwong et al. (2020) suggest the threat of rapid change in society during the pandemic has led to higher anxiety levels in younger people, who may feel more vulnerable to this change as typically have less housing and financial security.”

• cites Kwong et al. (2020)Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

All cases had Cook's distance less than 1 and leverage and Mahalanobis distances within acceptable ranges.

“All cases had Cook's distance less than 1 and leverage values and Mahalanobis distances within the acceptable range (Field, 2018).”

• cites Field, 2018Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Few participants were recruited from outside the UK and Ireland, limiting conclusions about country of residence.

“Additionally, few participants were recruited from outside the UK and Ireland, limiting conclusions about country of residence.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Anonymity may have mitigated perceived social desirability bias.

“However, anonymity may have mitigated against perceived social desirability bias.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Self-report measures may have introduced subjective bias affecting accuracy and reliability.

“The cross-sectional study design prevented causal inferences being made and self-report measures may have introduced subjective bias affecting accuracy and reliability.”

Classified as probably not a substantial claim.

Variance inflation factor and tolerance statistics were within accepted ranges.

“Variance inflation factor (VIF) and tolerance statistics were within accepted ranges (Field, 2018).”

• cites Field, 2018Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

The current study supports previous psychological flexibility findings through replication and extends them by contrasting variables to establish relative associations with anxiety and wellbeing.

“The current study supports these findings through replication and extends them by contrasting these variables with other predictors to establish their relative associations with anxiety and wellbeing.”

May combine two claims.

The age-anxiety finding provides evidence for stressors beyond health threat, suggesting containment measures are associated with increased anxiety.

“We suggest these findings provide evidence for stressors beyond a threat to health, suggesting containment measures themselves are also associated with increased anxiety.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The mediation effects were relatively strong based on the beta values shown on the paths.

“The mediation effects are relatively strong, based on the beta values shown on the paths.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Merwin et al. described intolerance of uncertainty of bodily functions and appetite as a core feature in their psychological flexibility conceptualization of Anorexia Nervosa.

“Merwin et al. (2011) further described intolerance of the uncertainty of bodily functions and appetite as a core feature in their PF conceptualization of Anorexia Nervosa.”

• cites Merwin et al. (2011) sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Psychological flexibility is a protective factor moderating the impact of daily stressors and threatening life events for depression, anxiety and life satisfaction.

“This is consistent with previous findings that higher PF is associated with positive psychological outcomes (Hayes et al., 2006) and a protective factor moderating the impact of daily stressors and threatening life events for depression, anxiety and life satisfaction (Gloster et al., 2017).”

• cites Gloster et al., 2017 sourceNot checked — no full text of the source

Classified as probably not a substantial claim.

Anxiety is the outcome of a threat appraisal where threat is perceived alongside an inability to cope with it.

“Cognitive accounts describe how anxiety is the outcome of a threat appraisal where threat is perceived alongside an inability to cope with it (Clark & Beck, 2010; Smith & Lazarus, 1993).”

• cites Clark & Beck, 2010Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Smith & Lazarus, 1993 sourceNot checked — no full text of the source

May combine two claims.

Psychological flexibility's ability to predict mental wellbeing may explain its association with lower anxiety because negative affectivity is recognized as a vulnerability to anxiety.

“PF's ability to predict mental wellbeing may also explain its association with lower anxiety as negative affectivity is recognized as a vulnerability to anxiety (Clark & Beck, 2010).”

• cites Clark & Beck, 2010Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S4 (based).

Use of social media for recruitment of a convenience sample is unlikely to be representative of the public more widely.

“The use of social media for recruitment of a convenience sample means it is unlikely to be representative of the public more widely.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Some CompACT items are suggestive of the prospective anxiety construct in intolerance of uncertainty.

“Furthermore, some items from the CompACT such as “I find it difficult to stay focussed on what's happening in the present” are suggestive of the prospective anxiety construct in IU.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Contextual factors were not standardized measures but were face valid and designed to capture likely influences on wellbeing and anxiety.

“The contextual factors were not standardized measures, but were face valid, designed to capture aspects of the context that were considered likely to influence wellbeing and anxiety.”

Probably not a substantial claim: may not pass S2 (checkable).

ACT and its emphasis on psychological flexibility could be a useful lens to develop large-scale interventions to support mental wellbeing during public health crises.

“the transdiagnostic approach of ACT and its emphasis on psychological flexibility suggest it could be a useful lens to develop large-scale interventions to support mental wellbeing during public health crises.”

Classified as probably not a substantial claim.

Selection of predictor and outcome variables relied on logical and theoretical reasoning and previous research.

“Given the uniqueness of the COVID-19 situation, selection of predictor and outcome variables relied on logical and theoretical reasoning as well as previous research.”

May combine two claims.

Despite limitations, the state anxiety and wellbeing models were both significant and a broad range of predictor variables were investigated.

“Despite these limitations, the model predicting state anxiety and the model predicting wellbeing were both significant and a broad range of predictor variables covering both contextual and psychological factors were investigated.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

People may be less likely to complete an online survey when highly anxious or complete it when experiencing uncharacteristically elevated anxiety, potentially over- or underestimating sample anxiety.

“For example, people may be less likely to complete an online survey when feeling highly anxious or alternatively complete the survey when experiencing uncharacteristically elevated anxiety symptoms. This may lead to either an over or under estimate of the level of anxiety in the sample.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Observed relationships may in practice be reversed or bidirectional.

“Therefore, observed relationships may in practice be reversed or bidirectional.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Use of a current-state anxiety measure may have gained sensitivity to context at the expense of stability.

“A state measure of anxiety was chosen to capture sensitivity to context, in comparison to trait-based measures, this sensitivity may however have been gained at the expense of stability.”