Intolerance of Uncertainty, Fear of Contamination and Perceived Social Support as Predictors of Psychological Distress in NHS Healthcare Workers during the COVID-19 Pandemic
Open accessAbstract
Psychological distress has been repeatedly quantified over the course of the pandemic, however this has not always included broader healthcare workers, and has mostly focused on prevalence and occupational factors. This study investigated intolerance of uncertainty (IOU), fear of contamination and perceived social support as key predictors of psychological distress in healthcare professionals, between the 10th and 23 June 2020, during the first wave of the COVID-19 pandemic. This study was a cross-sectional, online survey design. Opportunity sampling was used to recruit to the study, primarily using social media sites and snowballing techniques. The final sample included 342 National Health Service (NHS) healthcare workers. IU (p < .001), gender (p < .001), fear of contamination (p = .007), perceived social support (p = .012), and age (p = .017) significantly predicted psychological distress in the sample and accounted for 36.2% of variance in psychological distress scores. IOU accounted for 28.2% of this variance. A two-way post hoc ANOVA, looking at gender and profession, showed a significant main effect of gender on psychological distress scores (F(1,218) = 7.156, p = .008, ηp2 = .032), with females reporting significantly higher psychological distress scores compared to males. In conclusion, higher levels of intolerance of uncertainty, fear of contamination and lower levels of perceived social support significantly influenced higher scores of psychological distress. These factors should be considered when adapting and delivering evidence-based interventions to healthcare staff during this crisis.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Those with higher intolerance to uncertainty also experienced higher levels of stress.
“It should be remarked that, according to the literature, those with higher intolerance to uncertainty also experienced higher levels of stress [56], neuroticism, extraversion, and conscientiousness [16].”
From Impact of Stress during COVID-19 Pandemic in Italy: A Study on Dispositional and Behavioral Dimensions for Supporting Evidence-Based Targeted Strategies (2024) · cites this paper as [56]
Cites
Stress, social support, and the buffering hypothesis
Cohen, S., & Wills, T. A. (1985) · Psychological Bulletin · doi:10.1037/0033-2909.98.2.310 · Cited by 18,093 · see citing works
The psychological impact of quarantine and how to reduce it: Rapid review of the evidence
Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. J. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30460-8 · Cited by 16,378 · see citing works
Lovibond, P. F., & Lovibond, S. H. (1995) · Behaviour Research and Therapy · doi:10.1016/0005-7967(94)00075-u · Cited by 14,523 · see citing works
The Multidimensional Scale of Perceived Social Support
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988) · Journal of Personality Assessment · doi:10.1207/s15327752jpa5201_2 · Cited by 13,339 · see citing works
Henry, J. D., & Crawford, J. R. (2005) · British Journal of Clinical Psychology · doi:10.1348/014466505x29657 · Cited by 5,801 · see citing works
Holmes, E. A., O'Connor, R. C., Perry, V. H., Tracey, I., Wessely, S., Arseneault, L., Ballard, C., Christensen, H., Cohen Silver, R., Everall, I., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30168-1 · Cited by 5,715 · see citing works
Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed
Xiang, Y.-T., Yang, Y., Li, W., Zhang, L., Zhang, Q., Cheung, T., & Ng, C. H. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30046-8 · Cited by 3,598 · see citing works
Fearing the unknown: A short version of the Intolerance of Uncertainty Scale
Carleton, R. N., Norton, M. A. P. J., & Asmundson, G. J. G. (2007) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2006.03.014 · Cited by 2,288 · see citing works
The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus.
Kang, L., Li, Y., Hu, S., Chen, M., Yang, C., Yang, B. X., Wang, Y., Hu, J., Lai, J., Ma, X., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30047-x · Cited by 2,061 · see citing works
Shanafelt, T., Ripp, J., & Trockel, M. (2020) · JAMA · doi:10.1001/jama.2020.5893 · Cited by 1,956 · see citing works
The prevention and handling of the missing data
Kang, H. (2013) · Korean Journal of Anesthesiology · doi:10.4097/kjae.2013.64.5.402 · Cited by 1,728 · see citing works
Sex differences in anxiety and depression clinical perspectives
Altemus, M., Sarvaiya, N., & Neill Epperson, C. (2014) · Frontiers in Neuroendocrinology · doi:10.1016/j.yfrne.2014.05.004 · Cited by 1,413 · see citing works
The intolerance of uncertainty scale: psychometric properties of the English version
Buhr, K., & Dugas, M. J. (2002) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(01)00092-4 · Cited by 1,391 · see citing works
International Journal of Mental Health and Addiction
(2013) · International Journal of Mental Health and Addiction · doi:10.1007/11469.1557-1882 · Cited by 1,058 · see citing works
Hu, D., Kong, Y., Li, W., Han, Q., Zhang, X., Zhu, L. X., Wan, S. W., Liu, Z., Shen, Q., Yang, J., et al. (2020) · EClinicalMedicine · doi:10.1016/j.eclinm.2020.100424 · Cited by 936 · see citing works
Knowledge, attitude, and practice regarding COVID-19 among healthcare workers in Henan, China
Zhang, M., Zhou, M., Tang, F., Wang, Y., Nie, H., Zhang, L., & You, G. (2020) · Journal of Hospital Infection · doi:10.1016/j.jhin.2020.04.012 · Cited by 889 · see citing works
Depression, anxiety, stress levels of physicians and associated factors in Covid-19 pandemics
Elbay, R. Y., Kurtulmuş, A., Arpacıoğlu, S., & Karadere, E. (2020) · Psychiatry Research · doi:10.1016/j.psychres.2020.113130 · Cited by 845 · see citing works
Psychosocial effects of SARS on hospital staff: survey of a large tertiary care institution
Nickell, L. A. (2004) · Canadian Medical Association Journal · doi:10.1503/cmaj.1031077 · Cited by 711 · see citing works
Burns, G. L., Keortge, S. G., Formea, G. M., & Sternberger, L. G. (1996) · Behaviour Research and Therapy · doi:10.1016/0005-7967(95)00035-6 · Cited by 667 · see citing works
Brooks, S. K., Dunn, R., Amlôt, R., Rubin, G. J., & Greenberg, N. L. (2017) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000001235 · Cited by 547 · see citing works
Sinclair, S. J., Siefert, C. J., Slavin-Mulford, J. M., Stein, M. B., Renna, M., & Blais, M. A. (2012) · Evaluation & the Health Professions · doi:10.1177/0163278711424282 · Cited by 543 · see citing works
Rettie, H., & Daniels, J. (2021) · American Psychologist · doi:10.1037/amp0000710 · Cited by 526 · see citing works
Psychological Predictors of Anxiety in Response to the H1N1 (Swine Flu) Pandemic
Wheaton, M. G., Abramowitz, J. S., Berman, N. C., Fabricant, L. E., & Olatunji, B. O. (2012) · Cognitive Therapy and Research · doi:10.1007/s10608-011-9353-3 · Cited by 509 · see citing works
Birrell, J., Meares, K., Wilkinson, A., & Freeston, M. (2011) · Clinical Psychology Review · doi:10.1016/j.cpr.2011.07.009 · Cited by 459 · see citing works
Maunder, R. (2004) · Philosophical Transactions of the Royal Society B Biological Sciences · doi:10.1098/rstb.2004.1483 · Cited by 405 · see citing works
Psychological health during the coronavirus disease 2019 pandemic outbreak
Mukhtar, S. (2020) · International Journal of Social Psychiatry · doi:10.1177/0020764020925835 · Cited by 382 · see citing works
Marjanovic, Z., Greenglass, E. R., & Coffey, S. (2007) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2006.02.012 · Cited by 372 · see citing works
Mental health of staff working in intensive care during Covid-19
Greenberg, N. L., Weston, D., Hall, C. E., Caulfield, T., Williamson, V., & Fong, K. J. (2020) · Occupational Medicine · doi:10.1093/occmed/kqaa220 · Cited by 369 · see citing works
Perceptions and experiences of healthcare workers during the COVID-19 pandemic in the UK
Vindrola‐Padros, C., Andrews, L., Dowrick, A., Djellouli, N., Fillmore, H., Bautista-González, E., Javadi, D., Lewis‐Jackson, S., Manby, L., Mitchinson, L., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2020-040503 · Cited by 283 · see citing works
Lluch, C., Galiana, L., Doménech, P., & Sansó, N. (2022) · Healthcare · doi:10.3390/healthcare10020364 · Cited by 281 · cited 1× · see citing works
“During and beyond the pandemic, lack of adequate protection and high pressure on UK NHS personnel has been widely reported (Lluch et al., 2022).”
BackgroundConversano, C., Di Giuseppe, M., Miccoli, M., Ciacchini, R., Gemignani, A., & Orrù, G. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01900 · Cited by 259 · see citing works
Beaufort, I. N., Oene, G. H. D. W.-V., Buwalda, V. J. A., de Leeuw, J. R. J., & Goudriaan, A. E. (2017) · European Addiction Research · doi:10.1159/000485182 · Cited by 205 · see citing works
Sirois, F. M., & Owens, J. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2020.589545 · Cited by 194 · see citing works
Tracing “Fearbola”: Psychological Predictors of Anxious Responding to the Threat of Ebola
Blakey, S. M., Reuman, L., Jacoby, R. J., & Abramowitz, J. S. (2015) · Cognitive Therapy and Research · doi:10.1007/s10608-015-9701-9 · Cited by 164 · see citing works
Psychological Predictors of Health Anxiety in Response to the Zika Virus
Blakey, S. M., & Abramowitz, J. S. (2017) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-017-9514-y · Cited by 159 · see citing works
Common mental health disorders — identification and pathways to care: NICE clinical guideline
Kendrick, T., & Pilling, S. (2011) · British Journal of General Practice · doi:10.3399/bjgp12x616481 · Cited by 128 · see citing works
Wheaton, M. G., Messner, G. R., & Marks, J. B. (2021) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2020.100605 · Cited by 111 · see citing works
Tull, M. T., Barbano, A. C., Scamaldo, K. M., Richmond, J. R., Edmonds, K. A., Rose, J. P., & Gratz, K. L. (2020) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2020.102290 · Cited by 98 · see citing works
Ortiz-Calvo, E., Martínez‐Alés, G., Mediavilla, R., González-Gómez, E., Fernández-Jiménez, E., Bravo‐Ortiz, M. F., & Moreno‐Küstner, B. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.12.030 · Cited by 94 · see citing works
Robichaud, M. (2013) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2012.09.001 · Cited by 86 · see citing works
Haig-Ferguson, A., Cooper, K., Cartwright, E., Loades, M. E., & Daniels, J. (2021) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465820000636 · Cited by 84 · see citing works
Moorthy, A., & Sankar, T. K. (2020) · Journal of Public Health · doi:10.1093/pubmed/fdaa096 · Cited by 57 · see citing works
Cognitive–behavioural therapy for obsessive–compulsive disorder
Veale, D. (2007) · Advances in Psychiatric Treatment · doi:10.1192/apt.bp.107.003699 · Cited by 37 · see citing works
Daniels, J., Ingram, J. C., Pease, A. S., Wainwright, E. M., Beckett, K., Iyadurai, L., Harris, S., Donnelly, O., Roberts, T., & Carlton, E. W. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18189675 · Cited by 17 · see citing works
The Mental Health Impact of the COVID-19 Pandemic Second Wave on Shielders and Their Family Members
Daniels, J., & Rettie, H. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19127333 · Cited by 8 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Compassion fatigue in healthcare providers: a scoping review
Garnett, A., Hui, L., Oleynikov, C., & Boamah, S. A. (2023) · BMC Health Services Research · doi:10.1186/s12913-023-10356-3 · Cited by 114 · see citing works
Green, Z. A., Çi̇çek, İ., & Yıldırım, M. (2024) · Psihologija · doi:10.2298/psi220903002g · Cited by 38 · see citing works
O'Hare, D., Gaughran, F., Stewart, R. J., & da Costa, M. P. (2024) · BJPsych Open · doi:10.1192/bjo.2024.7 · Cited by 36 · see citing works
Seiler, A., Milliken, A. B., Leiter, R. E., Blum, D., & Slavich, G. M. (2024) · Comprehensive Psychoneuroendocrinology · doi:10.1016/j.cpnec.2024.100226 · Cited by 31 · see citing works
Intolerance of uncertainty and mental wellbeing: the mediating and moderating role of doomscrolling
Kaya, B., & Griffiths, M. D. (2024) · Behaviour and Information Technology · doi:10.1080/0144929x.2024.2314747 · Cited by 27 · see citing works
Bredemeier, K., Church, L. D., Bounoua, N., Feler, B., & Spielberg, J. M. (2023) · Journal of Anxiety Disorders · doi:10.1016/j.janxdis.2022.102660 · Cited by 18 · see citing works
Compassion fatigue in healthcare providers during the COVID-19 pandemic: a scoping review protocol
Hui, L., Garnett, A., Oleynikov, C., & Boamah, S. A. (2023) · BMJ Open · doi:10.1136/bmjopen-2022-069843 · Cited by 11 · see citing works
Oviedo, D. C., Tratner, A. E., Pinzón, M. S., Rodríguez-Araña, S., Pauli-Quirós, E., Chavarría, C., Rodríguez, C. P., & Britton, G. B. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1235935 · Cited by 10 · see citing works
Parvaresh‐Masoud, M., Abdollahyar, A., Molavi‐Taleghani, Y., Salahi, S., & Farahmandnia, H. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1212769 · Cited by 9 · see citing works
Chaaya, R., Hallit, R. R., Postigo, Á., Malaeb, D. N., Sakr, F., Dabbous, M., Alhuwailah, A., Shuwiekh, H. A. M., Obeïd, S., Fekih‐Romdhane, F., et al. (2024) · BMC Psychology · doi:10.1186/s40359-024-01631-x · Cited by 9 · see citing works
Ashtari, S., Rahimi‐Bashar, F., Karimi, L., Salesi, M., Guest, P. C., Riahi, M. M., Vahedian‐Azimi, A., & Sahebkar, A. (2023) · Advances in experimental medicine and biology · doi:10.1007/978-3-031-28012-2_4 · Cited by 7 · see citing works
Mao, Z., Qin, T., Fan, L., Li, N., & Wang, Y. (2023) · Current Psychology · doi:10.1007/s12144-023-05156-1 · Cited by 7 · see citing works
Day to Day and Environmental Risk Factors for Psychological Distress Among Healthcare Workers
Atkins, K., Cooney, E. E., Park, S., Closser, S., Surkan, P. J., Marker, H. C., Schneider-Firestone, S., Kalb, L. G., Thrul, J., & Veenema, T. G. (2023) · Journal of Occupational and Environmental Medicine · doi:10.1097/jom.0000000000002909 · Cited by 4 · see citing works
Ilyas, U., Aslam, F., Fatima, M., Tariq, Z., & Hotiana, U. A. (2024) · PubMed Central · Cited by 4 · see citing works
Caci, B., & Giordano, G. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13133911 · Cited by 3 · see citing works
Khozaei, F., Carbon, C., Islam, Q. U., & Ravari, Z. K. (2025) · The Open Psychology Journal · doi:10.2174/0118743501364500250515043823 · Cited by 3 · see citing works
It Absolutely Broke Me: A Psychoanalytic Exploration of the Staff Experience of COVID-19
Ramsey, S. M., Hurst, H., & Foster, C. (2025) · Qualitative Health Research · doi:10.1177/10497323251401829 · Cited by 4 · see citing works
Silva, A. J., Kulyk, M., & Caetano, A. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22040592 · Cited by 4 · see citing works
Cho, E., Hong, J., Kim, H., Park, C. H. K., Hong, Y., Park, J., Jun, J. Y., & Chung, S. (2023) · Journal of Korean Medical Science · doi:10.3346/jkms.2023.38.e282 · Cited by 2 · see citing works
Mental suffering among public and private assistance professionals during the COVID-19 pandemic
Guimarães, G. C., Pereira, G. S., dos Santos, H. C. N. T. R., Vianna, E. C. D. C., Peixoto, T. A. L., Silva-Júnior, J. S., & Gallasch, C. H. (2024) · Revista Brasileira de Medicina do Trabalho · doi:10.47626/1679-4435-2024-1227 · Cited by 2 · see citing works
Özden, E., & Ermiş, E. N. (2024) · Pamukkale University Journal of Social Sciences Institute · doi:10.30794/pausbed.1476833 · Cited by 2 · see citing works
Hansen, H., Schäfer, I., Dröge, F., Menzel, A., Tajdar, D., Mayer-Runge, U., Lühmann, D., & Scherer, M. (2023) · Zeitschrift für Evidenz Fortbildung und Qualität im Gesundheitswesen · doi:10.1016/j.zefq.2023.01.005 · Cited by 2 · see citing works
Rehman, S. U., REHMAN, A., ELAHI, A., RAFIQ, M., KHAN, R., JAFFAR, F., AIN, Q., Awan, S., MUJAHID, M., Rahim, N. F., et al. (2023) · Biological and Clinical Sciences Research Journal · doi:10.54112/bcsrj.v2023i1.418 · Cited by 2 · see citing works
Особистісні предиктори толерантності до невизначеності майбутніх педагогів
Halian, I. (2023) · Insight the psychological dimensions of society · doi:10.32999/2663-970x/2023-10-7 · Cited by 2 · see citing works
Platania, G. A., Varrasi, S., Guerrera, C. S., Boccaccio, F. M., Torre, V., Vezzosi, V. F., Pirrone, C., & Castellano, S. (2024) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph21030330 · Cited by 1 · see citing works
“It should be remarked that, according to the literature, those with higher intolerance to uncertainty also experienced higher levels of stress [56], neuroticism, extraversion, and conscientiousness [16].”
BackgroundTan, A. J. Q., Quinlan, E., & Smoak, M. (2025) · Australian Psychologist · doi:10.1080/00050067.2025.2542740 · Cited by 2 · see citing works
Anxiety during the COVID-19 Pandemic: Prevalence, Effects and Predisposing Factors
Şebnem, A. K. A. N. (2023) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.1263730 · Cited by 2 · see citing works
Ne’eman-Haviv, V., Dolberg, P., Lev, S., & Kagan, M. (2024) · Journal of Gerontological Social Work · doi:10.1080/01634372.2024.2442013 · Cited by 3 · see citing works
dos Santos, S. A., Garcia, W. J., Alvim, A. L. S., Barbosa, N. G., de Paiva, E. P., & Carbogim, F. D. C. (2023) · Revista Enfermagem UERJ · doi:10.12957/reuerj.2023.72660
Assessment on Mental Health Status During Post Covid-19 Pandemic
-, R. S., Mishra, S., -, U. V. K., & Sharmila, K. (2023) · International Journal For Multidisciplinary Research · doi:10.36948/ijfmr.2023.v05i04.6033
Carrillo, I., Poblete, R., Serpa, P., Martín-Delgado, J., Giménez, A., & Mira, J. J. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1215693
Terzi̇, B., Azizoğlu, F., & Seven, Ç. (2023) · Makara Journal of Health Research · doi:10.7454/msk.v27i3.1513
Kaya, B., Sarpkaya, A., & Önder, F. C. (2025) · Türk Psikolojik Danışma ve Rehberlik Dergisi · doi:10.17066/tpdrd.1533628 · Cited by 1 · see citing works
Kenarlı, Ö., Akyıl, Y., Erdinç, B., Sabaner, C., & Yaniger, B. (2025) · Psychiatric Quarterly · doi:10.1007/s11126-025-10234-7
Khamis, F. A., Badahdah, A. M., & Aloud, N. (2025) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.70320 · Cited by 1 · see citing works
Zeng, C., & Odufuwa, F. (2025) · Journal of Contingencies and Crisis Management · doi:10.1111/1468-5973.70099
- Authors
- Beck, E., & Daniels, J.
- Affiliations
- University of Bath (GB)
- Corresponding author
- Daniels, Jo
- Venue
- Psychology, Health & Medicine
- Publisher
- Informa UK Limited
- Published
- 2022-07-06
- Volume
- 28
- Issue
- 2
- Pages
- 447-459
- ISSN
- 1354-8506 (ISSN-L)
- 1465-3966
- OpenAlex
- W4284704638
- Cited by
- 36
- References
- 45
- Citations by year
- 2025: 8 · 2024: 11 · 2023: 16 · 2022: 1
- FWCI
- 8.21
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Psychology Health & Medicine (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- funding
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Health Sciences › Health Professions › General Health Professions › Healthcare professionals’ stress and burnout
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- intolerance of uncertainty, fear of contamination, perceived social support, psychological distress, healthcare workers, COVID-19 pandemic, NHS staff, gender differences, occupational stress, mental health of healthcare workers
- MeSH terms
- Psychological Distress, COVID-19, SARS-CoV-2, Cross-Sectional Studies, Fear, Female, Health Personnel, Humans, Male, Social Support, State Medicine, Uncertainty, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
