Multiple forms of mass anxiety in coronavirus disease-2019 pandemic

BACKGROUND: Heightened public anxiety was observed at the early stage of the COVID-19 pandemic. Our study enriches scholarly understanding of this mass response by investigating both generic and pandemic-specific anxiety that explain preventive health behavior. METHODS: In our two-phase, mixed-methods study, pandemic-specific anxiety items elicited during the qualitative phase from March 2–8, 2020 were then tested in the quantitative phase from March 16–22, 2020. Eligible participants were U.S. or U.K. residents aged 18–65. RESULTS: Of the 1,400 participants, 52% met the criteria for moderate to severe anxiety. In addition to anxiety over possible personal COVID-19 infection, participants were also anxious about others’ health, others’ reactions (e.g., panic-buying, discrimination), societal problems (e.g., economic slowdown, healthcare system breakdown), and personal finances. The positive association between generic anxiety and hygiene practice frequency was explained by two interpersonal-oriented forms of pandemic-specific anxiety: anxiety over others’ health (b = 0•0040, 95% CI: 0•0031–0•0050) and others’ reactions (0•0031, 0•0021–0•0042). LIMITATIONS: The study was conducted with participants from developed countries at an early stage of the pandemic, and the results were not necessarily generalizable to developing countries or other stages of the pandemic. Also, hygiene practices was the sole behavior of interest, and the findings may differ for other behaviors. CONCLUSIONS: The new findings indicate the importance of adopting a nuanced approach that unveils the multifaceted nature of anxiety using a mixed-methods design. Individuals from COVID-19-affected regions experience pandemic-specific anxiety due to concerns related to not only personal but also interpersonal-oriented issues.