Phenotyping mental health: age, community size, and depression differently modulate COVID-19-related fear and generalized anxiety

Abstract

Introduction When the first COVID-19 infections were reported in Germany, fear and anxiety spread faster than the pandemic itself. While moderate amounts of fear of a COVID-19 infection may be functional, generalized anxiety and the potentially resulting distress and psychopathology may possibly be detrimental to people's health. Authorities need to avoid a countrywide panic, on the one hand, but foster a realistic awareness of the actual threat, on the other hand. Objectives The current cross-sectional study aimed to investigate psychological reactions in response to the real or perceived infection threats. In particular, the analysis should reveal whether COVID-19-related fear and generalized anxiety in times of COVID-19 have distinct correlates. Methods A nationwide study was conducted from March 10th to May 4th 2020 in Germany (n = 15,308; 10,824 women, 4433 men, 51 other). Generalized anxiety was assessed using the GAD-7, while COVID-19-related fear was measured using a self-generated item. Both outcome variables were entered into linear regression models. Demographic information, depressive symptoms, trust in governmental interventions, subjective level of information regarding COVID-19 and media use were used to predict generalized anxiety and COVID-19-related fear. Results The data revealed distinct correlates of COVID-19-related fear and generalized anxiety. Although COVID-19-related fear and generalized anxiety had overlapping predictors, such as neuroticism, they most prominently differed in age distribution and direction of an urban-rural disparity: generalized anxiety decreases with age, but COVID-19-related fear is most pronounced in elderly participants. Generalized anxiety is also more prevalent in rural communities, but COVID-19-related fear is elevated in metropoles. Furthermore, the presence of a risk disease increases COVID-19-related fear, but not generalized anxiety. Conclusion These results suggest that COVID-19-related fear is often justified considering the individual risk of infection or complication due to infection. Some of the characteristics that predict COVID-19-related fear leave generalized anxiety unaffected or show divergent predictive directions. The present findings hint toward two related, but discriminant constructs.