Correction: Effect of the "Art Coloring" Online Coloring Game on Subjective Well-Being Increase and Anxiety Reduction During the COVID-19 Pandemic: Development and Evaluation.

[This corrects the article DOI: 10.2196/37026.].

Effect of the "Art Coloring" Online Coloring Game on Subjective Well-Being Increase and Anxiety Reduction During the COVID-19 Pandemic: Development and Evaluation.

BACKGROUND: COVID-19 has spread worldwide and generated tremendous stress on human beings. Unfortunately, it is often hard for distressed individuals to access mental health services under conditions of restricted movement or even lockdown. OBJECTIVE: The study first aims to develop an online digital intervention package based on a commercially released coloring game. The second aim is to test the effectiveness of difference intervention packages for players to increase subjective well-being (SWB) and reduce anxiety during the pandemic. METHODS: An evidence-based coloring intervention package was developed and uploaded to an online coloring game covering almost 1.5 million players worldwide in January 2021. Players worldwide participated to color either 4 rounds of images characterized by awe, pink, nature, and blue or 4 rounds of irrelevant images. Participants' SWB and anxiety and the perceived effectiveness of the game in reducing anxiety (subjective effectiveness [SE]) were assessed 1 week before the intervention (T1), after the participants completed pictures in each round (T2-T5), and after the intervention (T6). Independent 2-tailed t tests were conducted to examine the general intervention (GI) effect and the intervention effect of each round. Univariate analysis was used to examine whether these outcome variables were influenced by the number of rounds completed. RESULTS: In total, 1390 players worldwide responded and completed at least 1 assessment. Overall, the GI group showed a statistical significantly greater increase in SWB than the general control (GC) group (N=164, t162=3.59, Cohen d=0.59, 95% CI 0.36-1.24, P<.001). Compared to the control group, the best effectiveness of the intervention group was seen in the awe round, in which the increase in SWB was significant (N=171, t169=2.51, Cohen d=0.39, 95% CI 0.10-0.82, P=.01), and players who colored all 4 pictures had nearly significant improvements in SWB (N=171, F4,170=2.34, partial ŋ2=0.053, P=.06) and a significant decrease in anxiety (N=171, F4,170=3.39, partial ŋ2=0.075, P=.01). CONCLUSIONS: These data indicate the effectiveness of online psychological interventions, such as coloring games, for mental health in the specific period. They also show the feasibility of applying existing commercial games embedded with scientific psychological interventions that can fill the gap in mental crises and services for a wider group of people during the pandemic. The results would inspire innovations to prevent the psychological problems caused by public emergencies and encourage more games, especially the most popular ones, to take more positive action for the common crises of humankind.

Does COVID-19 threat increase xenophobia? The roles of protection efficacy and support seeking.

BACKGROUND: In response to the COVID-19 pandemic, people in many countries have shown xenophobia toward China, where the pandemic began. Within China, xenophobia has also been observed toward the people of Wuhan, the city where the first cases were identified. The relationship between disease threat and xenophobia is well established, but the reasons for this relationship are unclear. This study investigated the mediation role of perceived protection efficacy and moderation role of support seeking in the relationship between perceived COVID-19 risk and xenophobia within China. METHODS: An online survey was administered to a nationally representative sample (N = 1103; 51.7% women; ages 18 to 88) of Chinese adults during the early stage of the COVID-19 pandemic. Participants completed questionnaires about their perceived COVID-19 risk, perceived protection efficacy in reducing risk, support seeking, and xenophobic attitudes toward people of the Wuhan area. RESULTS: Regression based analyses showed that the perceived COVID-19 risk positively predicted xenophobia. Low perceived protection efficacy partly mediated the relationship between perceived COVID-19 risk and xenophobic attitudes, and this indirect effect was moderated by support seeking. Specifically, the indirect effect was weaker among individuals who sought more social support. CONCLUSIONS: Under disease threat, xenophobia can appear within a country that otherwise seems culturally homogeneous. This study extends the extant research by identifying a possible psychological mechanism by which individuals' perception of disease threat elicits xenophobia, and by addressing the question of why this response is stronger among some people than others. Increasing the public's perceived efficacy in protecting themselves from infection, and encouraging support seeking, could reduce xenophobic attitudes.

COVID-19 threat and xenophobia: A moderated mediation model of empathic responding and negative emotions

The threat of disease is associated with xenophobia, but limited research is available to shed light on the underlying processes that shape this relationship. Based on integrated threat theory and existing research, we tested a model in which the association between threat of disease and xenophobia is mediated by negative emotions, and how the process is moderated by empathic responding to others who are concerned about the disease threat. The research was conducted in China during the early phases of the COVID-19 pandemic with the focus on Chinese unease about the people of Wuhan, the city where the pandemic began. A national sample of Chinese adults (N = 1697) completed a survey on their perceptions of risk due to COVID-19, negative emotions experienced during the pandemic, empathic responses to others who were concerned about COVID-19, and xenophobia expressed toward people from Wuhan. The results showed that negative emotions mediated the relationship between perceived COVID-19 threat and xenophobia. However, contrary to expectation, empathic responding did not weaken the relation between perceived COVID-19 threat and xenophobia;instead, it exacerbated the relationship. Specifically, empathic responding to help others in the context of concerns about COVID-19 was related to greater xenophobia toward the out-group (i.e., the people of Wuhan).

Three Versions of the Perceived Stress Scale: Psychometric Evaluation in a Nationally Representative Sample of Chinese Adults during the COVID-19 Pandemic.

(1) Background: The COVID-19 outbreak has created pressure in people's daily lives, further threatening public health. Thus, it is important to assess people's perception of stress during COVID-19 for both research and practical purposes. The Perceived Stress Scale (PSS) is one of the most widely used instruments to measure perceived stress; however, previous validation studies focused on specific populations, possibly limiting the generalization of results. (2) Methods: This study tested the psychometric properties of three versions of the Chinese Perceived Stress Scale (CPSS-14, CPSS-10, and CPSS-4) in the Chinese general population during the COVID-19 pandemic. A commercial online survey was employed to construct a nationally representative sample of 1133 adults in Mainland China (548 males and 585 females) during a one-week period. (3) Results: The two-factor (positivity and negativity) solution for the three versions of the CPSS showed a good fit with the data. The CPSS-14 and CPSS-10 had very good reliability and the CPSS-4 showed acceptable reliability, supporting the concurrent validity of the CPSS. (4) Conclusions: All three versions of the CPSS appear to be appropriate for use in research with samples of adults in the Chinese general population under the COVID-19 crisis. The CPSS-10 and CPSS-14 both have strong psychometric properties, but the CPSS-10 would have more utility because it is shorter than the CPSS-14. However, the CPSS-4 is an acceptable alternative when administration time is limited.