By: Arbi Kumi, FCLC ‘21
The coronavirus (COVID-19) pandemic has had tremendous impacts on mental health. This study examined the relationships between the Big Five personality traits, various anxiety constructs, and concerns toward the pandemic in a sample of undergraduates from a private, 4-year university in the Northeast. Participants completed an online survey in October 2020 measuring their levels of coronavirus reassurance-seeking behaviors, coronavirus concerns, general anxiety, health anxiety, worry, and identification with Big Five personality domains. The sample consisted of N = 27 participants (M = 21.89 years, age range = 19–37, 74% female). High Neuroticism was significantly correlated with greater overall coronavirus concerns, health-related concerns, generalized anxiety, health anxiety, and worry. Additionally, worry was identified as a particularly strong predictor of overall coronavirus and health-related concerns, as well as Neuroticism, relative to general anxiety and health anxiety. The current findings offer insight into how Neuroticism and worry during the COVID-19 pandemic are related to coronaphobia.
COVID-19 Fears and Personality: Worry and Neuroticism Predict Coronaphobia
Since early 2020, the world has been caught in a public health crisis surrounding the rapid spread of the coronavirus disease 2019 (COVID-19), an infectious pneumonia caused by the SARS-CoV-2 virus. By March 2021, 1 year after the World Health Organization (WHO) declared COVID-19 a pandemic, there were over 120 million confirmed cases of COVID-19 and nearly 3 million confirmed deaths globally as a result of the outbreak (WHO, 2020a; WHO, 2020b). In the United States alone, there have been almost 30 million confirmed cases and over 500,000 deaths attributed to COVID-19 (WHO, 2020b). The coronavirus pandemic has uprooted the lives of people of all ages around the world, with factors such as social isolation, routine disruptions, fear of infection, and economic distress negatively affecting the mental health of a variety of population cohorts internationally (Khan et al., 2020).
Within the United States, understanding the mental health impact of the coronavirus pandemic on college students is of particular importance. According to the Centers for Disease Control and Prevention (CDC), the weekly incidence of COVID-19 among persons aged 18–22 years increased by 55% nationally over a 5-week period starting in early August 2020, with the greatest rise (144%) in the Northeast (Salvatore et al., 2020). These numbers are alarming, given that the prevalence of major depressive disorder (MDD) and generalized anxiety disorder (GAD) was 35% and 39%, respectively, in earlier stages of the pandemic, when COVID-19 incidence rates were lower (Chrikov et al., 2020). Furthermore, the prevalence of MDD and GAD was nearly 60% among undergraduates who struggled adapting to remote instruction (Chrikov et al., 2020).
A few studies have identified the mental health impacts of the early phases of the pandemic on undergraduates in the Northeast, where the current study draws its sample from. Using longitudinal data from 217 Dartmouth College undergraduate students from August 2017 to March 2020, Huckins et al. (2020) found that, compared to the end of previous academic terms, students reported significantly higher rates of depressive and anxious symptoms at the end of the winter 2020 academic term, which aligned with COVID-19 being declared a national emergency and Dartmouth College implementing campus restrictions and a switch to online learning. Although depression and anxiety levels began to simultaneously decrease at week 10 of the winter 2020 term, they never returned to baseline levels at the semester’s start or at the end of previous semesters. In another study assessing 162 undergraduates in New Jersey, Kecojevic et al. (2020) found that in April 2020, two-thirds of participants were very or extremely concerned about the COVID-19 outbreak. These individuals were more likely to report symptoms of anxiety and somatization.
Personality, Anxiety, and Coronaphobia
In its early stages, the COVID-19 pandemic had profound negative effects on the mental health of U.S. college students, and the drastic rise of new cases among this group may lead to an increased prevalence of such problems. However, as Kecojevic and colleagues (2020) note, few studies have investigated the specific factors, particularly at the individual level, that may contribute to poorer mental health and well-being in undergraduates during this time. One individual difference that may be implicated is personality (Aschwanden et al., 2021). According to the five-factor model of personality described by McCrae and John (1992), the Big Five personality traits are Neuroticism (also referred to by its opposite, Emotional Stability), Extraversion, Agreeableness, Conscientiousness, and Openness to Experience (Gosling et al., 2003).
Recent research has shown that the Big Five personality traits, especially Neuroticism, are associated with various aspects of health anxiety and health-related behaviors in adults, such as “coronaphobia,” defined as fear and anxiety of COVID-19 (Asmundson & Taylor, 2020a). Lee and colleagues (2020) found that Neuroticism was significantly associated with coronaphobia and that the two, along with health anxiety, were significant predictors of death anxiety, generalized anxiety, and depression. Lee and Crunk (2020) also identified significant correlations between Neuroticism and depression, generalized anxiety, health anxiety, coronaphobia, and coronavirus reassurance-seeking behaviors (CRSB), or repetitive attempts to relieve anxiety by making sure one is not ill. While these two studies operationalized coronaphobia as physiological symptoms of anxiety experienced over COVID-19, the current study describes coronaphobia as fear and anxiety of the coronavirus and its potential effects. Coronaphobia was thus measured in three different ways: CRSB, attitudes toward the pandemic, and concerns about the pandemic’s effects on one’s health, personal relationships, future career development, and community. Aschwanden et al. (2021) found positive correlations between endorsement of these four concerns and Neuroticism. Most recently, Nikčević et al. (2021) studied over 500 U.S. adults to find that, among the Big Five personality traits, only Neuroticism was positively correlated with health anxiety, GAD, and COVID-19 anxiety (i.e., coronaphobia). The researchers further noted a positive correlation between health anxiety and coronaphobia, which were both positively associated with GAD.
The Current Study
The present study aimed to validate previous research by identifying correlations between Neuroticism and coronaphobia, health anxiety, and general anxiety in a sample of undergraduate students in the Northeast. Excessive health anxiety is not only damaging to mental health, but it may encourage dangerous behaviors such as avoidance of hospitals when sick because of contagion fears (Asmundson & Taylor, 2020b). Elucidating the specific factors associated with health anxiety in undergraduates is crucial in order to best understand how to communicate with this population vis-à-vis public health matters. The current study also contributes to the burgeoning literature by serving as a point of comparison for similar studies conducted during the outbreak’s earlier and future phases.
Using Aschwanden and colleagues’ (2021) research as a primary framework, associations between the Big Five personality variables and various forms of coronaphobia (i.e., overall coronavirus concerns and the constituent domains of health, relationships, future, and community) were investigated. Consistent with their findings, it was hypothesized that Neuroticism would be significantly positively correlated with greater overall coronavirus concerns, health concerns, and relationship concerns. Furthermore, as Lee and Crunk’s (2020) results have suggested, it was predicted that greater Neuroticism would be significantly associated with higher levels of generalized anxiety, health anxiety, worry, and CRSB.
A sample of 27 college students (M = 21.89 years, SD = 4.18, age range = 19–37) from a private, 4-year undergraduate university in the Northeast was recruited to participate in the current study. Seventy-four percent (n = 20) of participants were female, 22% (n = 6) were male, and one participant identified as non-binary. Exactly two thirds (66.7%) of participants were 3rd-year students, and one third (33.3%) were 4th-year students. Eleven participants (40.7%) identified as White/Caucasian (not Hispanic), four (14.8%) identified as Arab American/Middle Eastern, three (11.1%) identified as Asian or Pacific Islander, three (11.1%) identified as Black or African American, two (7.4%) identified as Hispanic or Latin American, and four (14.8%) identified as multiracial.
The data were collected in October 2020 through Qualtrics, an internet-based survey platform. The survey contained questions belonging to parts of other empirical studies and were thus not included for analysis. The current study procedure was approved by the Fordham University Institutional Review Board. All participants received and acknowledged informed consent prior to starting the survey.
Coronavirus Reassurance-Seeking Behaviors. The Coronavirus-Reassurance Seeking Behaviors Scale (CRSBS; α = .90), a 5-item, Likert-type scale, was administered to measure reassurance-seeking health behaviors with regard to COVID-19 (Lee et al., 2020). Participants were asked to rate on a 5-point scale of 0 (not at all) to 4 (nearly every day over the last 2 weeks) how frequently they engaged in various reassurance-seeking behaviors over the last 2 weeks, with higher scores indicating greater frequency of CRSB. All five items were averaged to create a CRSB composite variable. Internal reliability was .66 in the current study.
Coronavirus Attitudes. Attitudes toward the coronavirus pandemic were assessed using a modified version of part of Aschwanden et al.’s (2021) study survey. Participants rated how much they agreed or disagreed with nine statements about the coronavirus on a scale (α = .74) ranging from 1 (strongly disagree) to 5 (strongly agree). A coronavirus attitudes composite variable was created, in which higher scores indicated greater negative attitudes toward the coronavirus. Thus, higher composite scores indicated more negative attitudes toward COVID-19. A coronavirus attitudes composite variable was created.
Coronavirus Concerns. Concerns about the effects of the COVID-19 pandemic were measured using a modified version of Aschwanden et al.’s (2021) coronavirus concerns scale. Participants were asked to rate their levels of concern for 11 items on a scale (α = .85) of 1 (not at all concerned) to 5 (extremely concerned). Items gauged participants’ concerns across four primary dimensions: concerns about (1) mental and physical health (of self and family; α = .82), (2) relationships (friends and family; α = .89), (3) the future (education and career; α = .86), and (4) the local and national community (unemployment, food insecurity, U.S. economy; α = .73). Composite variables were created to reflect the four dimensions, as well as an overall coronavirus concerns score. Higher scores indicated greater coronavirus-related concerns.
Health Anxiety. The Short Health Anxiety Inventory (SHAI; α = .89), an 18-item questionnaire, was administered to assess health anxiety (Salkovskis et al., 2002). Participants were presented with 14 groups of four statements about health-related attitudes and behaviors and asked to select the statement in each group that best described their feelings over the past 6 months. Participants were then presented with four groups of four statements about expected attitudes toward contracting the coronavirus (modified from the original, which asked participants to imagine contracting any serious illness) and asked to select the statement in each group which best describes what they think might happen. All item responses were coded on a scale of 1 to 4, with higher scores indicating greater health anxiety. All 18 items were averaged to create a health anxiety composite variable. Cronbach’s alpha for the current study was .94.
Generalized Anxiety. The Generalized Anxiety Disorder 7-item Scale (GAD-7; α = .92) was used to measure GAD symptoms (Spitzer et al., 2006). Participants labeled how frequently they have been bothered by typical anxiety-related problems over the last 2 weeks on a 4-point scale ranging from 0 (not at all) to 3 (nearly every day). A general anxiety composite variable was calculated, with higher scores indicating greater general anxiety. Internal reliability in the current study was .91.
Worry. The Penn State Worry Questionnaire (PSWQ; α = .91–.95), a 16-item scale, was administered to specifically assess the anxious trait of worry (Meyer et al., 1990). Participants rated the degree to which certain statements about their own sense of worry apply to them on a 5-point scale ranging from 1 (not at all typical of me) to 5 (very typical of me). Higher scores indicated higher levels of worry. Five items in which lower scores indicated higher levels of worry were reverse scored such that higher composite scores indicated greater worry. A worry composite variable was calculated by averaging all 16 items. Cronbach’s alpha was .94 in the current study.
Big Five Personality Traits
Personality traits were assessed using the Ten-Item Personality Inventory (TIPI), which measures personality along the personality domains of Extraversion, Agreeableness, Conscientiousness, Emotional Stability (i.e., Neuroticism; low Emotional Stability corresponds to high Neuroticism), and Openness to Experiences (Gosling et al., 2003). Cronbach’s alpha for each dimension was found by Gosling et al. (2003) to be .68, .40, .50, .73, and .45, respectively. Participants indicated the extent to which a given pair of traits described themselves on a 7-point scale ranging from 1 (disagree strongly) to 7 (agree strongly). Composite variables for each personality trait were created, with higher scores indicating greater identification with a trait. Composite variables were created by averaging the two items assigned to each domain. Cronbach’s alpha in the present study was .92, .33, .68, and .53 for Extraversion, Conscientiousness, Emotional Stability, and Openness, respectively.
Mean scores and standard deviations for each composite variable across all participants are listed in Table 1. Despite low levels of CRSB, participants reported largely negative attitudes toward the coronavirus and moderate to high levels of coronavirus concerns. Among the four concerns domains, participants reported feeling the most concerned about the effects of the coronavirus on their local and national communities and the least concerned about its effects on their personal relationships. On average, the sample reported low levels of general anxiety, moderate levels of health anxiety, and high levels of worry. The two items meant to measure Agreeableness (Items 2 and 7) were not correlated and thus excluded from analysis. Among the four internally consistent personality domains, participants scored highest on Openness to Experiences and lowest on Emotional Stability, indicating high Neuroticism in the sample.
Zero-order correlations were conducted to test for bivariate relationships between variables (see Table 2). Among the four internally consistent personality dimensions, only Emotional Stability was significantly correlated with overall concerns related to COVID-19 (r(25) = -.606, p < .01) and with any anxiety construct. Low Emotional Stability/high Neuroticism was also significantly correlated with having more health concerns (r(25) = -.544, p < .01) and more future concerns (r(25) = -.573, p < .01). Emotional Stability was significantly negatively correlated with general anxiety (r(25) = -.732, p < .01), worry (r(25) = -.766, p < .01), and health anxiety (r(25) = -.587, p < .01).
Overall coronavirus concerns were significantly correlated with general anxiety (r(25) = .513, p <.01), worry (r(25) = .593, p < .01), and health anxiety (r(25) = .510, p < .01). However, health-specific concerns were more strongly correlated with worry (r(25) = .723, p < .01) than with either health anxiety (r(25) = .559, p < .01) or general anxiety (r(25) = .443, p < .05). Concerns that the coronavirus will negatively affect one’s future education and career were also significantly correlated with general anxiety (r(25) = .579, p < .01), worry (r(25) = .478, p < .05), and health anxiety (r(25) = .476, p < .05). Anxiety measured along any construct was not significantly related to relationship or community concerns.
Neuroticism was the only Big Five trait to be significantly correlated with multiple measures of coronaphobia and anxiety. Neuroticism was hypothesized to be significantly positively correlated with overall, health-related, and relationship-related COVID-19 concerns. The data partially supported this. Low Emotional Stability/high Neuroticism predicted greater overall coronavirus concerns and health concerns. However, contrary to research by Aschwanden et al. (2021), Emotional Stability was not correlated with relationship concerns. The only personality trait that had a statistically significant correlation with relationship concerns was Extraversion, such that lower ratings of Extraversion moderately predicted greater relationship-related concerns.
It was also hypothesized that Neuroticism would be significantly positively associated with CRSB, generalized anxiety, health anxiety, and worry. Again, the data partially supported this. Emotional Stability was not significantly correlated with CRSBS scores, as Lee and Crunk’s (2020) findings had suggested. However, consistent with Nikčević et al.’s (2021) findings, low Emotional Stability/high Neuroticism was significantly correlated with higher ratings on all three anxiety measures.
The present study was unique in that it included a measure of worry to determine if it correlates with coronaphobia or with personality traits in ways different from general or health anxiety. Research by Zebb and Beck (1998) suggests that worry and anxiety, though related, are associated with different domains. For example, characteristics such as negative affect and perceived personal control—which are especially salient in the context of a pandemic—are more representative of worry than of anxiety. Indeed, data analysis found that worry was more strongly correlated with overall coronavirus concerns and health concerns than either general or health anxiety. Health anxiety was also more strongly correlated with worry than with general anxiety. Additionally, among the three anxiety measures, worry was the most strongly related to Emotional Stability. Taken together, this suggests that worry is a useful construct to study in its own right when analyzing health anxiety and personality.
In contrast with undergraduate cohorts studied during the earlier stages of the COVID-19 pandemic (e.g., Kecojevic et al., 2020), general anxiety was relatively mild in the current sample. While this may reflect a growing desensitization to the coronavirus or increased resiliency (a question for future research), participants nonetheless expressed concerns about the pandemic and its consequences and reported high levels of worry. Thus, for college students in the later stages of the outbreak, the coronavirus continued to be a source of distress marked by the uncertainty of a post-pandemic world.
University students have faced unique challenges throughout the coronavirus pandemic. Major milestones such as graduation ceremonies have been in flux, online instruction has posed financial and practical burdens for some students, strict isolation measures have hampered social interaction and development, and a lack of internship and job opportunities has postponed career advancement (Khan et al., 2020). The pandemic has also negatively impacted academic performance among undergraduates, which may further exacerbate accompanying mental health problems (Kecojevic et al., 2020). Understanding how these factors are related to personality variables may elucidate the mental health impact of the pandemic on undergraduates, identify individuals at risk for experiencing negative mental health effects, and offer insight into effective prevention efforts and treatment. College is typically a high-stress period, and as such, university-based mental health services such as psychological counseling centers or peer support programs must consider the multifaceted interactions between personality, mental health, and academic achievement to provide students with effective assistance during the coronavirus pandemic. Lee and Crunk (2020) suggested rational-emotive therapies and internet-based cognitive behavior therapy as useful tools for reducing Neuroticism and thereby curbing coronavirus-related anxiety and depression. Implementing therapies specifically targeting Neuroticism may be considerably helpful for individuals coping with the psychological distress of living during and after the pandemic.
Using a large, international community sample, Harper and colleagues (2020) found moderate-to-strong correlations between fear and measures of anxiety and depression. However, the researchers also found that fear had a functional role: individuals with greater coronaphobia were more likely to respond to the pandemic by engaging in adaptive precautionary actions such as regular hand washing and social distancing. To prevent pathologizing healthy individuals during a psychologically distressing time, it is therefore critical that mental health professionals carefully consider the range of behaviors and emotions that are considered normative and protective during a pandemic. Several of these behaviors may be better understood through a personality lens. For example, Aschwanden et al. (2021) found that adopting precautionary behaviors was significantly correlated with high Conscientiousness and low Neuroticism, and engaging in preparatory behaviors (e.g., buying face masks, stocking up on hand sanitizer) was significantly positively correlated with Extraversion. Heightened coronaphobia as a result of high Neuroticism may also increase self-exposure to COVID-19 news coverage, which Huckins et al. (2020) found rises with increased levels of anxiety and depression. It is thus as important for public health officials as it is for mental health professionals to consider the role of personality in public health messaging in order to minimize negative triggers and maximize compliant behaviors, which is especially pertinent as the United States continues its current vaccination campaign (Asmundson and Taylor, 2020b).
Limitations and Future Directions
There were several limitations to this study, the biggest being its small sample size, which may narrow the generalizability of the results. A small sample might explain why several significant associations between variables found in previous research (such as those between Big Five traits other than Neuroticism with measures of coronaphobia and anxiety) may not have appeared in the current study (Aschwanden et al., 2021). A small sample also prevented adequate analysis of sociodemographic variables in relation to the study variables. The present study also relied on a convenience sample that may not be representative of the university from which it came or of the U.S. undergraduate population.
There are several methodological limitations as well. To avoid asking participants too many questions, the brief TIPI was used to measure personality traits. However, post hoc analysis revealed that the two items designed to measure Agreeableness were not internally consistent. The 44-item Big Five Inventory is a suitable alternative, as its length may help yield more reliable results (John et al., 1991). Additionally, although all four coronavirus concern domains were internally consistent, each consisted of just two or three items. Future research studying these domains should include more questions in the scales measuring them.
Unlike many previous studies, the current study did not analyze the prevalence and role of depressive symptoms within the context of coronaphobia and personality (Chirikov et al., 2020; Kecojevic et al., 2020; Nikčević et al., 2021). Future studies must consider anxiety symptoms alongside symptoms of MDD, as research has shown that the pandemic has increased the prevalence of depressive symptoms among this population (Chirikov et al., 2020). Furthermore, the current study did not measure engagement in precautionary or preparatory behaviors, as Aschwanden et al. (2021) did, to determine any personality correlates, which is yet to be studied in undergraduates. As vaccines continue to be delivered across the country, future research should investigate the role of personality and other psychological constructs with regard to vaccine hesitancy or resistance. Moving forward, it is important that professionals in mental health, medicine, and public health better understand the consequences that individual-level differences in personality may have in influencing undergraduate attitudes and mental health during a pandemic.
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