Exploring Factors and Associate Responses for Anxiety in the Coronavirus Disease 2019 Pandemic: A Web-Based Survey in Japan

Jinman Zhuang; Guoxi Cai; Yixiao Lu; Xinying Xu; Yulan Lin; Li Ping Wong; Zhijian Hu; Taro Yamamoto; Kouichi Morita; Kiyoshi Aoyagi; Fei He

doi:10.3389/fpsyg.2021.795219

Exploring Factors and Associate Responses for Anxiety in the Coronavirus Disease 2019 Pandemic: A Web-Based Survey in Japan

Front Psychol. 2022 Mar 8:12:795219. doi: 10.3389/fpsyg.2021.795219. eCollection 2021.

Authors

Jinman Zhuang¹, Guoxi Cai^{1

2

3}, Yixiao Lu⁴, Xinying Xu¹, Yulan Lin¹, Li Ping Wong⁵, Zhijian Hu¹, Taro Yamamoto³, Kouichi Morita⁶, Kiyoshi Aoyagi¹, Fei He¹

Affiliations

¹ Fujian Provincial Key Laboratory of Environment Factors and Cancer, Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China.
² Department of Public Health, Nagasaki Prefectural Institute of Environment and Public Health, Nagasaki, Japan.
³ Department of International Health, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.
⁴ Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
⁵ Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
⁶ Department of Virology, Institute of Tropical Medicine (NEKKEN), Nagasaki University, Nagasaki, Japan.

Abstract

Background and objectives: Anxiety plays an important role in psychology. An exploration of anxiety and its associated reactions may provide insight into measures for addressing mental health problems caused by the coronavirus disease 2019 (COVID-19) pandemic. Data from this study provide potential correlational responses to anxiety.

Methods: A cross-sectional study using data collected via an online self-reported questionnaire was conducted in Japan during the COVID-19 pandemic. Using the State-Trait Anxiety Inventory (STAI-6), we assessed anxiety levels and explored the relationship between anxiety STAI-6 score, sources of COVID-19 information, the influences of COVID-19, social anxiety symptoms, discrimination, and evaluation of the government.

Results: A total of 4,127 participants were included in the analysis. The level of anxiety was not equally distributed across the general population with respect to age, gender, educational level, occupation, income, presence of underlying disease, and location (p < 0.05). The number of sources of information on COVID-19 had a positive correlation with the STAI-6 score (Spearman's rho = 0.176, p < 0.001). The influence of the pandemic was correlated with moderate-severe anxiety. A high level of anxiety added to social anxiety (Spearman's rho = 0.04, p < 0.05) and discriminatory behavior (Spearman's rho = 0.11, p < 0.01). Being female (Estimate = 0.926) and from a non-emergency area (Estimate = -0.308) was related to higher STAI scores, and higher education (Estimate = -0.305), and income (Estimate = -0.168) decreased the STAI score. The respondents who had a lower evaluative score of the preventive activities undertaken by the national and local governments had higher STAI-6 scores.

Conclusion: Our findings provide statistical evidence for the associated reaction of anxiety and that anxiety reactions may vary in predictable ways. Further studies should focus on the strategic interventions that may decrease the associated responses to anxiety, to address mental health issues due to the pandemic.

Keywords: COVID-19; STAI-6; anxiety; associate response; mental health.