Mediating Role of Coronavirus Anxiety in the Relationship between Intolerance of Uncertainty and Suicide Probability during COVID-19 Pandemic

Year 2022, Volume: 12 Issue: 3, 522 - 544, 15.12.2022

Şehide Kelek , Merve Sayıkoğlu Uçar , Nur Hilal Yıldırım , Betül Düşünceli

https://doi.org/10.19126/suje.1057831

Abstract

This research was designed to examine the mediating role of coronavirus anxiety in the relationship between intolerance of uncertainty and suicide probability among emerging adults. The study included 301 individuals (69.1% Female, 30.9% Male) aged 18-25. Coronavirus Anxiety Scale, Intolerance of Uncertainty Scale, and Suicide Probability Scale were used in the study. When the results were examined, it was found that those who had difficulty adjusting to the new normal and did not see quarantine as an opportunity were significantly more likely to suicide probabilities. They had higher levels of intolerance of uncertainty and coronavirus anxiety. In addition, coronavirus anxiety appears to play a partial mediating role between intolerance of uncertainty and suicide probability. The research indicated that emerging adults' intolerance of uncertainty and coronavirus anxiety levels affected their suicide probability.

Keywords

Intolerance of uncertainty, Coronavirus anxiety, Suicide probability, Emerging adulthood

References

• Anderson, R. (2002). Deaths: Leading causes for 2000. National Vital Statistics Reports, 50(16), 1-88.
• Arnett, J. J. (2000). Emerging adulthood: A theory of development from the late teens through the twenties. American Psychologist, 55(5), 469–480. https://doi.org/10.1037/0003-066X.55.5.469
• Bar-Anan, Y., Wilson, T. D., & Gilbert, D. T. (2009). The feeling of uncertainty intensifies affective reactions. Emotion, 9(1), 123-127. https://doi.org/10.1037/A0014607
• Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173-1182. https://doi.org/10.1037/0022-3514.51.6.1173
• Berenbaum, H., Bredemeier, K., & Thompson, R. J. (2008). Intolerance of uncertainty: Exploring its dimensionality and associations with need for cognitive closure, psychopathology and personality. Journal of Anxiety Disorders, 22(1), 117-125. https://doi.org/10.1016/j.janxdis.2007.01.004
• Bodrud-Doza, Md., Shammi, M., Bahlman, L., Tawfigul Islam, A. R. Md. & Rahman, M. Md. (2020). Psychosocial and socioeconomic crisis in Bangladesh due to covid-19 pandemic: A perception-based assessment. Frontiers Public Health, 26(8), 341. https://doi.org/10.3389/fpubh.2020.00341
• Bottesi, G., Noventa, S., Freeston, M. H., & Ghisi, M. (2019). Seeking certainty about intolerance of uncertainty: Addressing old and new issues through the Intolerance of Uncertainty Scale revised. Plos One, 14(2), 1-24. https://doi.org/10.1371/journal.pone.0211929
• Bozkurt, Y., Zeybek, Z., & Aşkın, R. (2020). Covid-19 pandemisi: Psikolojik etkileri ve terapötik müdahaleler [Covid-19 pandemic: Psychological effects and therapeutic interventions]. İstanbul Ticaret Üniversitesi Sosyal Bilimler Dergisi, 19(37), 304-318. http://hdl.handle.net/11467/4265
• Brooks, S., Webster, R., Smith, L., Woodland, L., Wessely, S., Greenberg, N., & Rubin, G. (2020). The psychological impact of quarantine and how to reduce it: Rapid review of the evidence. Lancet Psychiatry, 395(14), 912-920. https://doi.org/10.1016/S0140-6736(20)30460-8
• Buheji, M., Ahmed, D. & Jahrami, H. (2020). Living uncertainty in the new normal. International Journal of Applied Psychology, 10(2), 21-31. https://doi.org/10.5923/J.İjap.20201 002.01
• Buhr, K., & Dugas, M. J. (2009). The role of fear of anxiety and intolerance of uncertainty in worry: An experimental manipulation. Behaviour Research and Therapy, 47(3), 215–223. https://doi.org/10.1016/j.brat.2008.12.004
• Butola, L., Ambad, R., Gusain, N., & Dhok, A. (2020). Indoor activities for physical fitness during lockdown. Journal of Critical Reviews, 7(10), 542-545. https://doi.org/10.31838/jcr.07.10.108
• Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The psychological impact of the covid-19 epidemic on college students in China. Psychiatry Research, 287. https://doi.org/10.1016/J.Psychres.2020.112934
• Carleton, R. N. (2016). Into the unknown: A review and synthesis of contemporary models involving uncertainty. Journal of Anxiety Disorders, 39, 30-43. https://doi.org/10.1016/j.janxdis.2016.02.007
• Carleton, R. N., Duranceau, S., Shulman, E. P., Zerff, M., Gonzales, J. & Mishra, S. (2016). Self-reporter intolerance of uncertainty and behavioural decisions. Journal of Behavior Therapy and Experimental Psychiatry, 51, 58-65. https://doi.org/10.1016/j.jbtep.2015.12.004
• Chtourou, H., Trabelsi, K., H'mida, C., Boukhris, O., Glenn, J. M., Brach, M., & Bragazzi, N. L. (2020). Staying physically active during the quarantine and self-isolation period for controlling and mitigating the covid-19 pandemic: A systematic overview of the literature. Frontiers in Psychology, 11, 1708. https://doi.org/10.3389/fpsyg.2020.01708
• Ciarrochi, J., Said, T., & Deane, F. P. (2005). When simplifying life is not so bad: The link between rigidity, stressful life events, and mental health in an undergraduate population. British Journal of Guidance & Counselling, 33(2), 185-197. https://doi.org/10.1080/03069880500132540
• Cull, J. G. & Gill, W. S. (1988). Suicide probability scale (SPS) manual. Western Psychological Services.
• Çebi, E. (2020). Covid-19 salgını döneminde "normal" ve "yeni normal" yaşam üzerine bir araştırma [A research on “normal” and “new normal” lives during the covid-19 epidemic period]. Journal of International Social Research, 13(73), 582-593. https://doi.org/10.17719/jisr.11063
• Çölgeçen, Y. & Çölgeçen, H. (2020). Covid-19 pandemisine bağlı yaşanan kaygı düzeylerinin değerlendirilmesi: Türkiye örneği [Evaluation of anxiety levels arising from covid-19 pandemic: The case of Turkey]. Turkish Studies, 15(4), 261-275. http://dx.doi.org/10.7827/TurkishStudies.44399
• Dsouza, D. S., Quadros, S., Hyderabadwala, Z. J. & Mamun, M. A. (2020). Aggregated covid-19 suicide incidences in India: Fear of covid-19 infection is the prominent causative factor. Psychiatry Research, 290, 113145. https://doi.org/10.1016/j.psychres.2020.113145
• Dugas, M. J., Buhr, K., & Ladouceur, R. (2004). The role of intolerance of uncertainty in etiology and maintenance. In R. G. Heimberg, C. L. Turk, & D. S. Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice (pp. 143–163). Guilford Press.
• Dugas, M. J., Freeston, M. H., Blais, F. & Ladouceur, R. (1994, Nowember 10-13). Anxiety and depression in GAD patients, high and moderate worriers [Poster presentation]. Association for Advancament of Behavior Therapy 28th Annual Convention. San Diego, California, USA.
• Dugas, M. J., Gosselin, P., & Ladouceur, R. (2001). Intolerance of uncertainty and worry: Investigating specificity in a nonclinical sample. Cognitive Therapy and Research, 25(5), 551-558. https://doi.org/10.1023/A:1005553414688 Durkheim, E. (1951). Suicide. A study in sociology (J. A. Spaulding & G. Simpson, Trans.). The Free Press. (Original work published 1897)
• Evren, C., Evren, B., Dalbudak, E., Topcu, M., & Kutlu, N. (2020). Measuring anxiety related to Covid-19: A Turkish validation study of the Coronavirus Anxiety Scale. Death Studies, 1-7. https://doi.org/10.1080/07481187.2020.1774969
• Fraenkel, J. R., Wallen, N. & Hyun, H. (2012). How to design and evaluate research in education. Mc Graw Hill. Freeston, M. H., Rheaume, J., Letarte, H., Dugas, M. J., & Ladouceur, R. (1994). Why do people worry? Personality and Individual Differences, 17, 791-802. https://doi.org/10.1016/0191-8869(94)90048-5
• Gentes, E. L., & Ruscio, A. M. (2011). A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive-compulsive disorder. Clinical Psychology Review, 31(6), 923-933. https://doi.org/10.1016/j.cpr.2011.05.001
• Grenier, S., Barrette, A. M., & Ladouceur, R. (2005). Intolerance of uncertainty and intolerance of ambiguity: Similarities and differences. Personality and Individual Differences, 39(3), 593-600. https://doi.org/10.1016/j.paid.2005.02.014
• Gu, Y., Gu, S., Lei, Y., & Li, H. (2020). From uncertainty to anxiety: How uncertainty fuels anxiety in a process mediated by intolerance of uncertainty. Neural Plasticity, 2020:8866386. https://doi.org/10.1155/2020/8866386
• Güleç, G. (2016). Psikiyatrik bozukluklar ve intihar [Psychiatric disorders and suicide]. Türkiye Klinikleri Psychiatry Special Topics, 9(3), 21-25.
• Hawryluck, L., Gold, W. L., Robinson, S., Pogorski, S., Galea, S., & Styra, R. (2004). SARS control and psychological effects of quarantine, Toronto, Canada. Emerging Infectious Diseases, 10(7), 1206–1212. https://doi.org/10.3201/eid1007.030703 Hocaoğlu, Ç., & Erdoğan, A. (2020) Covid-19 ve intihar [COVID-19 and suicide]. In B. Coşar (Ed.), Psikiyatri ve Covid 19 (pp. 35- 42). Türkiye Klinikleri.
• Jenkinson, R., Milne, E., & Thompson, A. (2020). The relationship between intolerance of uncertainty and anxiety in autism: A systematic literature review and meta-analysis. Autism, 24(8), 1933-1944. https://doi.org/10.1177/1362361320932437
• John, A., Okolie, C., Eyles, E., Webb, R. T., Schmidt, L., McGuiness, L. A., Olorisade, B. K., Arensman, E., Howton, K., Kapur, N., Mordan, P., O’connor, R. C., O’Neill, S., Higgins, J. P. T., & Gunnell, D. (2020). The impact of the covid-19 pandemic on self-harm and suicidal behaviour. A Living Systematic Review, 9, 1097. https://doi.org/10.12688/f1000research.25522.1
• Kang, N., You, J., Huang, J., Ren, Y., Lin, M. P., & Xu, S. (2019). Understanding the pathways from depression to suicidal risk from the perspective of the interpersonal-psychological theory of suicide. Suicide and Life‐Threatening Behavior, 49(3), 684-694. https://doi.org/10.1111/sltb.12455
• Lee, S. A. (2020a). Coronavirus Anxiety Scale: A brief mental health screener for covid-19 related anxiety. Death Studies, 44(7), 393-401. https://doi.org/10.1080/07481187
• Lester, D. (1987). Suicide as a learned behavior. Charles C Thomas, Publisher.
• Lin, C. Y. (2020). Social reaction toward the 2019 novel coronavirus (Covid-19). Social Health and Behavior, 3 (1), 1–2. https://doi.org/10.4103/Shb.Shb_11_20
• Martin, R. L., Smith, N. S., Mcgrew, S. J., & Capron, D. W. (2019). Aggressive worriers: How aggression moderates the association between intolerance of uncertainty and suicidal desire constructs. Archives of Suicide Research: Official Journal of The International Academy for Suicide Research. Advance online publication. https://doi.org/10.1080/13811118.2019.1689877
• Mcclure, G. M. G. (2000). Changes in suicide in England and Wales, 1960–1997. The British Journal of Psychiatry, 176(1), 64-67. https://doi.org/10.1192/bjp.176.1.64
• Mcevoy, P. M., & Mahoney, A. E. (2012). To be sure, to be sure: Intolerance of uncertainty mediates symptoms of various anxiety disorders and depression. Behavior Therapy, 43(3), 533-545. https://doi.org/10.1016/j.beth.2011.02.007
• Memiş Doğan, M., & Düzel, B. (2020). Covid-19 özelinde korku-kaygı düzeyleri [Fear-anxiety levels in Covid-19]. Turkish Studies, 15(4), 739-752. https://Dx.Doi.Org/10.7827/Turkishstudies.44678
• Miranda, R., Fontes, M., & Marroquín, B. (2008). Cognitive content-specificity in future expectancies: Role of hopelessness and intolerance of uncertainty in depression and GAD symptoms. Behaviour Research and Therapy, 46(10), 1151-1159. https://doi.org/10.1016/j.brat.2008.05.009
• Morriss, J., Christakou, A., & Van Reekum, C. M. (2016). Nothing is safe: Intolerance of uncertainty is associated with compromised fear extinction learning. Biological Psychology, 121 (Pt B), 187-193. https://doi.org/10.1016/j.biopsycho.2016.05.001
• Nazman, E., Olmuş, H., & Erbaş, S. (2018). Türkiye’deki ergenler arasında intihar düşüncesini etkileyen potansiyel risk faktörlerinin incelenmesi [Investigating potential risk factors affecting on suicidal ideation among adolescents in Turkey]. Toplum ve Sosyal Hizmet, 29(2), 270-291. https://dergipark.org.tr/tr/pub/tsh/issue/39687/470025
• Norton, B. (2020, July 17). Eap and Covid-19: Psychological and emotional wellness in the workplace: Return to work during the pandemic: helping the distressed employee. http://Hdl.Handle.Net/10713/13333
• Oyuncakçı, S. (2020). 25-40 yaş arası yetişkinlerde intihar olasılığı, çocukluk çağı travmaları, psikolojik sağlamlık, affetme ve olumlu-olumsuz duygular arasındaki ilişkinin incelenmesi [The investigation of the relationship between suicide possibility, childhood trauma, resilience, forgiveness and positive-negative affect among 25-40 years individual]. [Master’s thesis, University of Bahçeşehir]. https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp
• Öztürk, Ö. (2013). İntihar olasılığı ve aile işlevselliği arasındaki ilişkide bilişsel esneklik ve belirsizliğe tahammülsüzlük değişkenlerinin aracı rolü. [Mediator role of cognitive flexibility and intolerance of uncertainty in relationship which between suicide probability and family functionality]. [Master’s thesis, University of Ankara]. https://tez.yok.gov.tr/UlusalTezMerkezi/tezSorguSonucYeni.jsp
• Pallant, J. (2005). SPSS survival manual. Mcgraw Hill.
• Pragholapati, A. (2020). New normal “Indonesia” after covid-19 pandemic. PsyArXiv. Advance online publication. https://doi.org/10.31234/osf.io/7snqb
• Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36(4), 717–731. https://doi.org/10.3758/BF03206553
• Preacher, K. J., & Hayes, A. F. (2008). Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior Research Methods, 40(3), 879–891. https://doi.org/10.3758/BRM.40.3.879
• Rettie, H., & Daniels, J. (2020). Coping and tolerance of uncertainty: Predictors and mediators of mental health during the Covid-19 pandemic. American Psychologist. Advance Online Publication. http://Dx.Doi.Org/10.1037/Amp0000710
• Sari, S., & Dağ, İ. (2009). Belirsizliğe Tahammülsüzlük Ölçeği, Endişe ile İlgili Olumlu İnançlar Ölçeği ve Endişenin Sonuçları Ölçeğinin Türkçeye uyarlanması, geçerliliği ve güvenilirliği [Problem solving style, hopelessness, helplessness and haplessness as the predictors of psychopathology assessed by MMPI-2]. Anadolu Psikiyatri Dergisi, 10(4), 261–270.
• Sauer, K. S., Jungmann, S. M. Witthöft, M. (2020). Emotional and behavioral consequences of the covid-19 pandemic: The role of health anxiety, intolerance of uncertainty and distress (in) tolerance. International Journal of Environmental Research and Public Health, 17(19), 7241. https://doi.org/10.3390/ijerph17197241
• Sher, L. (2020). The impact of the covid-19 pandemic on suicide rates. Qjm: Monthly Journal of The Association of Physicians, 113(10), 707–712. https://Doi.Org/10.1093/Qjmed/ Hcaa202
• Smith, B. M., Twohy, A. J., & Smith, G. S. (2020). Psychological inflexibility and intolerance of uncertainty moderate the relationship between social isolation and mental health outcomes during covid-19. Journal of Contextual Behavioral Science, 18, 162-174. https://doi.org/10.1016/j.jcbs.2020.09.005
• Sun, S., Goldberg, S. B., Lin, D., Qiao, S. & Operario, D. (2020). Psychiatric symptoms, risk, and protective factors among university students in quarantine during the covid-19 pandemic in China. Global Health, 17:15. https://doi.org/10.1186/s12992-021-00663-x
• Suokas, J., Suominen, K., Isometsä, E., Ostamo, A., & Lönnqvist, J. (2001). Long‐term risk factors for suicide mortality after attempted suicide‐findings of a 14-year follow‐up study. Acta Psychiatrica Scandinavica, 104(2), 117-121. https://doi.org/10.1034/j.1600-0447.2001.00243.x
• Tabachnick, B., & Fidell, L. (2013). Using multivariate statistics. Pearson.
• Tan, H. J., Marks, L. S., Hoyt, M. A., Kwan, L., Filson, C. P., Macairan, M. & Stanton, A. L. (2016). The relationship between intolerance of uncertainty and anxiety in men on active surveillance for prostate cancer. The Journal of Urology, 195 (6), 1724-1730. https://doi.org/10.1016/j.juro.2016.01.108
• Tanner, J. L. & Arnett, J. J. (2009). The emerge of ‘emerging adolthood’. In A.Furlong (Ed.), Handbook of youth and young adulthood (pp. 39-45). Routledge.
• Tecirli, N. D., Ucuz, G., & Ozel, F. (2020). İzolasyon, karantina, sosyal mesafe ve ruh sağlığı [Isolation, quarantine, social distancing and mental health]. The Bulletin of Legal Medicine, 25, 33-39. https://doi.org/10.17986/blm.2020.v25i.1412
• Topaloğlu, E. ve Atay, A. (2020). Kategorik verilerin analizinde logaritmik doğrusal modellerin kullanımı: İntihar olasılığı verileri üzerine bir uygulama [Use of logarithmic linear models in analysis of categorical data: An application on suicide risk data]. Optimum Ekonomi ve Yönetim Bilimleri Dergisi, 7(2), 565-580. https://doi.org/10.17541/optimum.686322 Turkish Statistical Institute [TurkStat] (2020). Suicide Statistics. https://www.tuik.gov.tr/
• Twardawski, M., Steindorf, L. & Thielmann, I. (2020). Three pillars of physical distancing: Anxiety, prosociality, and rule compliance during the covid-19 pandemic. PsyArXiv. Advance online publication. https://doi.org/10.31234/osf.io/zkfyb
• Van Orden, K. A., Witte, T. K., Cukrowicz, K. C., Braithwaite, S. R., Selby, E. A., & Joiner, T. E. (2010). The interpersonal theory of suicide. Psychological review, 117(2), 575–600. https://doi.org/10.1037/a0018697
• World Health Organization [WHO], (2019). Suicide Data (Report No. CC BY-NC-SA 3.0 IGO.) https://www.who.int/teams/mental-health-and-substance-use/suicide-data
• Yip, P. S. F., Cheung, Y. T., Chau, P. H., & Law, Y. W. (2010). The impact of epidemic outbreak: The case of Severe Acute Respiratory Syndrome (SARS) and suicide among older adults in Hong Kong. Crisis, 31 (2), 86-92. https://Doi.Org/10.1027/0227-5910/A00005
• Yook, K., Kim, K., Suh, S., & Lee, K. (2010). Intolerance of uncertainty, worry, and rumination in major depressive disorder and generalized anxiety disorder. Journal of Anxiety Disorders, 24(6), 623–628. https://doi.org/10.1016/j.janxdis.2010.04.003
• Zhang, J., & Li, Z. (2013). The association between depression and suicide when hopelessness is controlled for. Comprehensive psychiatry, 54(7), 790–796. https://doi.org/10.1016/j.comppsych.2013.03.004
• Zhou, K. & Zacharias, J. (2020). The impact of out-of-home leisure before quarantine and domestic leisure during quarantine on subjective well-being. Leisure Studies. https://doi.org/10.1080/02614367.2020.1843693
• Zhuo, K., & Zacharias, J. (2020). The impact of out-of-home leisure before quarantine and domestic leisure during quarantine on subjective well-being. Leisure Studies. Advance online publication. https://doi.org/10.1080/02614367.2020.1843693