Anxiety Sensitivity, COVID-19 Fear, and Mental Health: Results From a United States Population Sample

The COVID-19 pandemic has clearly had global physical, social, economic, and psychological impact worldwide. Across the world, there are approximately 95 million cases of COVID-19 with over 2 million people who have died as a result ( In the United States, approximately 400,000 people have died with over 2 million infected with COVID-19 ( Although the recent availability of two COVID-19 vaccines has provided a ray of hope, the virus at this time appears to remain highly transmissible. Understandably, fear of COVID-19, as well as the impact of COVID-19 on mental health in general, is likely to be a continuing issue for some time.  Therefore, in our study, we wanted to better understand the relationship between COVID-19 fear, anxiety sensitivity (fear of benign bodily sensations like increased heart rate) and mental health outcomes, we conducted a study using a large United States sample of 5,023 individuals to better understand the relationship among these factors.

Data were collected between June 22nd and July 5th of 2020. We used a large sample of 5,023 individuals from across the United States who were broadly representative of the population. In order to collect the data, individuals were sent the study survey through the Qualtrics Panels platform. Study participants completed questions about their fear of COVID-19, anxiety sensitivity which measures a person’s beliefs about the feared consequences of anxiety across cognitive, physical and social concerns, depression, and generalized anxiety. We also asked study participants about their COVID-19 exposure which was defined as they themselves had been tested positive for COVID-19, had an immediate family member or significant other with COVID-19, or had another family member or friend with COVID-19.

We found in our study that fear of COVID-19 was high, with 44% of our group reporting greater than average COVID-19 fear. In contrast, we found that clinically significant rates of depression or anxiety were lower than COVID-19 fear, with 15.1% of the study participants reporting depression and 14.4% reporting anxiety. Individuals who had higher total anxiety sensitivity also had higher COVID-19 fear although only the physical and cognitive subscales of anxiety sensitivity contributed to this relationship. Additionally, individuals with higher total anxiety sensitivity were also those individuals who were more likely to have COVID-19 fear which was also related to greater rates of depression and anxiety. Mediation analyses showed that COVID-19 fear partially mediated the associations between anxiety sensitivity and anxiety/depression. COVID-19 exposure did not have an impact on any of these variables, nor did other demographic factors such as gender, race/ethnicity, or occupation.

Our study results suggest that having a fear of bodily sensations leads to greater fear of COVID-19, which in turn leads to greater levels of general anxiety and depression. This information might help guide metnal health interventions when working to reduce the psychological distress individuals may experience as a result of the pandemic. Future research to test such interventions is important to deliver evidence based strategies to cope with COVID-19.

Read the full paper:  Warren AM, Zolfaghari K, Fresnedo M, Bennett M, Pogue J, Waddimba A, Zvolensky  M, Carlbring P, Powers MB. (in press). Anxiety sensitivity, COVID-19 fear, and mental health: Results from a United States population sample. Cognitive Behaviour Therapy. doi:10.1080/16506073.2021.1874505

Photo by: Mike Finn

Pictured: Ann Marie Warren, PhD
Pictured: Mark Powers, PhD

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