Effects of anxiety sensitivity, disgust, and intolerance of uncertainty on the COVID stress syndrome: a longitudinal assessment of transdiagnostic constructs and the behavioural immune system

Cogn Behav Ther. 2021 May;50(3):191-203. doi: 10.1080/16506073.2021.1877339. Epub 2021 Feb 12.

Abstract

Excessive fear and worry in response to the COVID-19 pandemic (e.g., COVID stress syndrome) is prevalent and associated with various adverse outcomes. Research from the current and past pandemics supports the association between transdiagnostic constructs-anxiety sensitivity (AS), disgust, and intolerance of uncertainty (IU)-and pandemic-related distress. Recent research suggests a moderating effect of disgust on the relationship of AS-physical concerns and COVID-19-related distress, suggesting that transdiagnostic constructs underlie individual differences in activation of the behavioral immune system (BIS). No previous study has examined the independent and conjoint effects of pre-COVID-19 AS-physical concerns, disgust propensity (DP), disgust sensitivity (DS), and IU in this context; thus, we did so using longitudinal survey data (N = 3,062 Canadian and American adults) with simple and moderated moderations controlling for gender, mental health diagnosis, and COVID-19 diagnosis. Greater AS-physical concerns, DP, and DS predicted more severe COVID stress syndrome assessed one month later. Either DP or DS further amplified the effect of AS-physical concerns on COVID stress syndrome, except danger and contamination fears. IU did not interact with AS-physical concerns and DS or DP. Theoretical and clinical implications pertaining to delivery of cognitive behavioural therapy for pandemic-related distress are discussed.

Keywords: COVID-19; anxiety; anxiety sensitivity; behavioral immune system; covid stress syndrome; disgust; intolerance of uncertainty; pandemics.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anxiety / immunology
  • Anxiety / psychology*
  • Anxiety Disorders / immunology
  • Anxiety Disorders / psychology
  • COVID-19
  • COVID-19 Testing
  • Canada
  • Disgust*
  • Fear / psychology*
  • Female
  • Humans
  • Immune System / immunology
  • Male
  • Middle Aged
  • Pandemics
  • Stress, Psychological / immunology
  • Stress, Psychological / psychology*
  • Uncertainty*