The Moderating Role of Intolerance of Uncertainty on the Relationship Between Health Anxiety and COVID-related Stress and Precautions

The effects of the coronavirus (COVID-19) have been significant for individuals with mental health conditions. Research has suggested that health anxiety (HA) may be associated with COVID-19-related fears. Intolerance of uncertainty (IU) is a transdiagnostic variable widely studied across anxiety disorders, including HA. IU is composed of both prospective (desire for predictability) and inhibitory (uncertainty paralysis) subscales. The present study examined the moderating effects of prospective and inhibitory IU on the relationship between HA and COVID-related stress, as well as COVID-related precautions (general precautions and delivery specific). Participants (n=202; M=37.27; 74.3% female; 66.34% White, non-Hispanic) were recruited via social media and community boards across the U.S. in August 2020, and completed self-report measures assessing HA, IU, and COVID-related stress and precautions. The prospective subscale of IU significantly moderated the association between HA and COVID-related stress, interaction β=.11, 95% CI [.01, .21]. The association between HA and COVID-related stress was strengthened at higher levels of prospective IU: low level (1 SD below mean), β=.19, 95% CI [.01, .38]; average level, β=.30, 95% CI [.17, .44); high level (1 SD above mean) β=.41, 95% CI [.27, .56]. Our findings did not show any significant interaction effects for general COVID-related precautions or delivery precautions as outcome variables. Our results suggest that individuals with elevated HA who also report high prospective IU are at higher risk of experiencing COVID stress. These results illuminate the interplay of risk factors that place anxious populations at higher risk of experiencing stress during acute health risks. Keywords: COVID-19, health anxiety, intolerance of uncertainty, stress, safety behavior