The role of perceived level of threat, reactance proneness, political orientation, and coronavirus salience on health behavior intentions.

OBJECTIVE: This pre-registered study was designed to test whether reminders of death and coronavirus would have similar or different effects on health behavior intentions concerning COVID-19 (e.g., mask wearing, social distancing) and whether the type of framing of these behaviors would moderate these effects. DESIGN: The study utilized a 3 (threat: mortality salience vs. coronavirus reminder vs. control topic) x 3 (framing: autonomy-supportive vs. controlled vs. neutral) design. Measures of perceived threat of COVID-19, reactance proneness, and political orientation were included as individual differences. RESULTS: Although the interaction between threat and framing conditions was not significant, the data revealed that (1) lower perceived threat of COVID-19 was associated with lower health behavior intentions to reduce the spread of the virus; (2) after an induction to express their thoughts and feelings about COVID-19, participants with low perceived threat of COVID-19 significantly increased their health intentions; (3) perceived threat of COVID-19 moderated the relationship between reactance proneness and health intentions, such that those high in reactance proneness reported lower intentions unless they had high perceptions of threat; and (4) politically conservative participants reported lower intentions to engage in healthy behaviors, and this relationship was mediated by their lower perceived threat of COVID-19.

Predictors of posttraumatic stress symptoms, COVID-related functional impairment, and burnout among medical professionals during the COVID-19 pandemic.

Physicians are particularly vulnerable to mental health symptoms during global stressors such as the COVID-19 pandemic. Such stressors can increase death anxiety, which is a vulnerability factor for psychological dysfunction. Thus, exposure to COVID-related death may play a unique role in physicians' mental health during the pandemic. This cross-sectional study collected self-reported data from 485 resident physicians and fellows. Participants reported mental health symptoms, including posttraumatic stress symptoms (PTSS), burnout, and functional impairment due to the pandemic. Participants also reported death anxiety, COVID-19 anxiety, cognitive accessibility of death-related thoughts (DTA), and workplace exposure to COVID-19. Death anxiety, COVID-19 anxiety, DTA, and workplace COVID-19 exposure all independently predicted PTSS. Furthermore, COVID-19 anxiety and DTA interacted to predict PTSS, such that high levels of COVID-19 anxiety predicted higher PTSS, regardless of DTA level. Death anxiety and COVID-19 workplace exposure interacted to predict PTSS as well, such that death anxiety predicted PTSS only when COVID-19 exposure was high. Burnout was predicted by COVID-19 anxiety and workplace exposure, and COVID-related functional impairment was predicted by death anxiety and COVID anxiety. These findings demonstrate that death-related and COVID-related concerns, independently and in interaction with each other, play an important role in psychological distress among physicians.

Terror Management Theory and the COVID-19 Pandemic

Terror management theory is focused on the role that awareness of death plays in diverse aspects of life. Here, we discuss the theory?s implications for understanding the widely varying ways in which people have responded to the COVID-19 pandemic. We argue that regardless of whether one consciously believes that the virus is a major threat to life or only a minor inconvenience, fear of death plays an important role in driving one?s attitudes and behavior related to the virus. We focus on the terror management theory distinction between proximal defenses, which are activated when thoughts of death are in current focal attention and are logically related to the threat at hand, and distal defenses, which are activated when thoughts of death are on the fringes of one?s consciousness and entail the pursuit of meaning, personal value, and close relationships. We use this framework to discuss the many ways in which COVID-19 undermines psychological equanimity, the diverse ways people have responded to this threat, and the role of ineffective terror management in psychological distress and disorder that may emerge in response to the virus.