The mediating role of fear of COVID-19 in the relationship between intolerance of uncertainty and depression.

Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 101135751 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2044-8341 (Electronic) Linking ISSN: 14760835 NLM ISO Abbreviation: Psychol Psychother Subsets: MEDLINE

Publication: 2011- : West Sussex, England : Wiley-Blackwell
Original Publication: Leicester, UK : British Psychological Society, c2002-

Attitude to Health* ; COVID-19* ; Uncertainty*; Depression/*psychology ; Depressive Disorder/*psychology ; Fear/*psychology; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Female ; Greece ; Humans ; Male ; Mediation Analysis ; Middle Aged ; Psychometrics/instrumentation ; Young Adult

Objectives: Living during the COVID-19 pandemic is characterized by the emergence of great uncertainty surrounding multiple aspects of daily life. This study explored the relationship between intolerance of uncertainty (IU) and depression, as well as the potential mediation effect of COVID-19-related fear.
Design and Methods: A cross-sectional study was conducted through an online survey from 10 April until 13 April 2020, three weeks after a national lockdown had been imposed in Greece. The convenience sample used in this study consisted of 2,827 adults. Participants voluntarily provided sociodemographic data and completed the following scales: the Intolerance of Uncertainty Scale (IUS-12), the Fear of COVID-19 Scale (FCV-19S), and the Brief Patient Health Questionnaire (PHQ-9) Depression Scale.
Results: Participants appeared to be moderately depressed [M = 14.75, SD = 4.52]. There was a significant indirect effect of IU to depressive symptoms ((.058), CI (0.051-0.066)). FCV-19S was tested as a mediator in the relationship between IUS-12 (independent variable) and PHQ-9 (dependent variable). Partial mediation of fear of COVID-19 was supported ((.54) (.41) = 13, CI (0.051-0.066), Sobel z-value = 14.93).
Conclusions: Depressive symptomatology affected study participants at a moderate level. IU was shown to be a significant predictor of depressive symptomatology with higher levels of IU being associated with more severe depressive symptoms. Fear of COVID-19 partially mediated this association. The mediation effect may be explained by the uncertainty around COVID-19-related health issues, which are reflected in the FCV-19S and cause worry and/or anxiety. Uncertainty related with other factors, such as the impact on the economy and education, not assessed by the FCV-19S, may explain part of the relationship between IU and depressive symptoms that is not mediated by FCV-19S.
Practitioner Points: Intolerance of uncertainty is related to depressive symptomatology, and fear of COVID-19 explains part of the relation. Fear of COVID-19 indicates worry and anxiety related to health issues. Psychotherapeutic interventions enhancing individuals' capacity to endure uncertainty could be beneficial. Provision of simple and clear information by the authorities should be a priority issue.
(© 2020 The British Psychological Society.)

Lancet. 2018 Nov 24;392(10161):2299-2312. (PMID: 30396512)
Arthritis Care Res (Hoboken). 2011 Sep;63(9):1313-21. (PMID: 21618450)
J Anxiety Disord. 2011 Jan;25(1):112-22. (PMID: 20828984)
J Anxiety Disord. 2008;22(3):505-14. (PMID: 17600670)
Int J Ment Health Addict. 2020 May 15;:1-12. (PMID: 32427165)
Br J Health Psychol. 2014 Sep;19(3):592-605. (PMID: 23834735)
Cogn Behav Ther. 2019 May;48(3):253-264. (PMID: 30354911)
Ann Intern Med. 2020 May 05;172(9):577-582. (PMID: 32150748)
Lancet. 2020 Mar 14;395(10227):912-920. (PMID: 32112714)
Expert Rev Neurother. 2012 Aug;12(8):937-47. (PMID: 23002938)
J Med Virol. 2020 Jun;92(6):568-576. (PMID: 32134116)
Front Psychiatry. 2020 Aug 19;11:821. (PMID: 32973575)
Int J Ment Health Addict. 2020 May 04;:1-10. (PMID: 32372892)
Int J Ment Health Addict. 2022;20(3):1537-1545. (PMID: 32226353)
Cogn Behav Ther. 2019 Mar;48(2):121-136. (PMID: 29882726)
Int J Surg. 2020 Jun;78:185-193. (PMID: 32305533)
Health Educ Behav. 2000 Oct;27(5):591-615. (PMID: 11009129)
J Anxiety Disord. 2007;21(1):105-17. (PMID: 16647833)
Clin Microbiol Infect. 2009 Aug;15(8):743-7. (PMID: 19754730)
J Anxiety Disord. 2010 Aug;24(6):623-8. (PMID: 20439149)
Asian J Psychiatr. 2017 Oct;29:129-133. (PMID: 29061409)
Int J Environ Res Public Health. 2020 Mar 06;17(5):. (PMID: 32155789)
Int J Ment Health Addict. 2021;19(6):2279-2288. (PMID: 32837420)
Health Commun. 2019 Apr;34(4):463-474. (PMID: 29313717)
J Gen Intern Med. 2001 Sep;16(9):606-13. (PMID: 11556941)
Cogn Behav Ther. 2016 Nov;45(6):431-44. (PMID: 27314213)
J Anxiety Disord. 2016 Apr;39:30-43. (PMID: 26945765)

Keywords: COVID-19; adult; depression; fear; greek; intolerance of uncertainty; mediation; mental health; pandemics

Date Created: 20201120 Date Completed: 20210817 Latest Revision: 20220727

20231215

PMC7753422

10.1111/papt.12315

33216444