Comparison of Psychological Distress and Coping Styles Usage in Different Levels of COVID-19 Anxiety in Students: A Descriptive Study

The coronavirus 2019 first spread from Wuhan, Hubei Province, China, and became a global epidemic in just two months, according to the World Health Organization. As of March 23, 2020, the unknown virus has spread rapidly worldwide, infecting more than 187 countries and killing a significant number of people worldwide. COVID-19 is an acute respiratory infectious disease characterized by the main symptoms of fever, cough, and shortness of breath. With the outbreak of COVID-19 and subsequent changes such as the closure of high-risk jobs and the implementation of emergency public health measures and home quarantine, social and economic relations and the way people lived were severely affected. During the spread of the virus, strict measures such as social distancing and mask-wearing were taken to control the spread of the disease in different parts of the world. One of the measures taken to curb COVID-19 was establishing home quarantine, which in turn can have a variety of consequences, including increased anxiety and stress. Patients with or suspected of COVID-19 are often afraid of the aftermath of the deadly virus, such as long-term health effects or death. People in quarantine may also experience fatigue, loneliness, depression, and anger. Additionally, common symptoms of COVID-19 such as fever, body aches, loss of taste and smell, hypoxia, cough, and dry throat can increase COVID-19 anxiety in patients, which may cause psychological distress. High levels of fatigue and anxiety resulting from quarantine conditions significantly increase the need for extreme care, but due to the unknown nature of coronavirus 2019 and the lack of definitive treatment, individuals may have difficulty responding to this need. This intensifies fear, anxiety, and depression in people. Another variable that can be associated with pandemic diseases, such as COVID-19, is coping styles and types of symptoms in high-stress patients. Since the beginning of the COVID-19 epidemic, there has been a wave of stress and anxiety, first among Chinese citizens and then around the world. People must use appropriate and effective coping strategies to control and reduce the stress caused by these conditions. Overall, COVID-19 anxiety, specifically health anxiety, can lead to cognitive errors, threat-related distortion, immunosuppressive behaviors, and destructive behaviors in healthy individuals who develop high levels of COVID-19 anxiety. In this regard, the present study aimed to compare psychological distress and coping styles in students with different levels of COVID-19 anxiety.

The research design was descriptive and causal-comparative. The statistical population of the study included undergraduate, graduate, and Ph.D. students of the University of Tehran, Iran, in the second semester of 2020-2021. In the present study, 200 students (100 students with high levels of COVID-19 anxiety and 100 students with low levels of COVID-19 anxiety) participated in the study through an online survey conducted via WhatsApp and Instagram. Inclusion criteria included belonging to the research community, having internet access, being between 18 and 30 years of age, and reporting personal satisfaction with their current living situation. The omission of questions was also considered as a criterion for leaving the research. Due to the epidemic of COVID-19, the closure of universities and educational institutions, and to prevent the spread of COVID-19, samples of this study were collected online. Participants were assessed using the COVID-19 Anxiety Inventory, psychological distress, and coping styles and then grouped. To identify students with COVID-19 anxiety, 338 questionnaires were distributed among the participants. Individuals who obtained a standard deviation above the mean COVID-19 anxiety scale were included in the analysis as a group with high levels of COVID-19 anxiety. Finally, data analysis was performed using multivariate and univariate variance with SPSS software version 24. It should be noted that in the present study, ethical considerations based on Helsinki ethics were observed.

The results of the Eta squared analysis show that the difference between the two groups in the studied variables is significant, with an Eta squared value of 0.71. This means that 71% of the variance related to the difference between the two groups is due to the interaction of COVID-19 anxiety and the studied variables. The results of multivariate analysis of variance showed that stress (68.55), anxiety (79.77), depression (94.17), Emotion-oriented Coping (98.81), Problem-oriented Coping (102.74), and Avoidance-oriented coping (114/48) were all significant at the level of 0.01. These findings indicate that there is a significant difference between the two groups in these variables (P<0.01). This means that students with different levels of COVID-19 anxiety differ in their use of psychological distress and coping styles. Specifically, students with high levels of COVID-19 anxiety had higher levels of psychological distress, emotion-oriented coping, and avoidance-oriented coping than students with low COVID-19 anxiety.

Findings from this study showed that students with high levels of COVID-19 anxiety have more depression, anxiety, and stress than other students. As a result, students with high levels of COVID-19 anxiety may become more sensitive to physical signs and symptoms, which can lead to increased levels of COVID-19 anxiety. On the other hand, the results of this study indicate that people with high levels of COVID-19 anxiety are less inclined to use problem-solving coping styles and are more likely to use emotion-oriented and avoidance-oriented coping styles. However, problem-solving coping styles can further reduce the harms of experiencing COVID-19 and the stress that results from it. Although stressors play an important role in exacerbating chronic and pandemic diseases, it should be borne in mind that how people deal with stressful situations plays an important role in their health. Therefore, psychologists and counselors need to pay more attention to these areas to reduce the severity of anxiety in students.