Effects of risk exposure on emotional distress among Chinese adults during the COVID-19 pandemic: The moderating role of disruption of life and perceived controllability.

Background: COVID-19 affects not only the physical health of individuals but also their mental health and different types of risk exposures are believed to have different effects on individual emotional distress.

Objective: This study explores the relationships between risk exposure, disruption of life, perceived controllability, and emotional distress among Chinese adults during the COVID-19 outbreak.

Methods: This study is based on an online survey conducted during the COVID-19 pandemic, from 1 to 10 February 2020, with a total of 2,993 Chinese respondents recruited through convenience and snowball sampling. Multiple linear regression analysis were used to examine the relationships among risk exposure, disruption of life, perceived controllability, and emotional distress.

Results: This study found that all types of risk exposures were significantly associated with emotional distress. Individuals with neighborhood infection, family member infection/close contact, and self-infection/close contact had higher levels of emotional distress ( = 0.551, 95% CI: -0.019, 1.121;  = 2.161, 95% CI: 1.067, 3.255;  = 3.240, 95% CI: 2.351, 4.129) than those without exposure. The highest levels of emotional distress occurred among individuals experiencing self-infection/close contact, while the lowest levels of emotional distress occurred among individuals experiencing neighborhood infection and the moderate levels of emotional distress occurred among individuals experiencing family member infection (Beta = 0.137; Beta = 0.073; Beta = 0.036). Notably, the disruption of life aggravated the effect of self-infection/close contact on emotional distress and family member infection/close contact on emotional distress ( = 0.217, 95% CI: 0.036, 0.398;  = 0.205, 95% CI: 0.017, 0.393). More importantly, perceived controllability lowered the strength of the association between self-infection/close contact and emotional distress, as well as family member infection/close contact and emotional distress ( = -0.180, 95% CI: -0.362, 0.002;  = -0.187, 95% CI: -0.404, 0.030).

Conclusion: These findings shed light on mental health interventions for people exposed to or infected with COVID-19 near the beginning of the pandemic, particularly those who themselves had COVID or had family members with COVID-19 risk exposure, including being infected/having close contact with an infected person. We call for appropriate measures to screen out individuals or families whose lives were, or remain, more severely affected by COVID-19. We advocate providing individuals with material support and online mindfulness-based interventions to help them cope with the after-effects of COVID-19. It is also essential to enhance the public's perception of controllability with the help of online psychological intervention strategies, such as mindfulness-based stress reduction programs and mindfulness-oriented meditation training programs.