What Makes Us Vulnerable To Covid-19 Fear?

Uppsala University's Philip Millroth discusses his new research examining the sources of Covid-19 fear.

By Mark Travers, Ph.D. | August 31, 2021

A new research paper published in the Journal of Anxiety Disorders attempts to make sense of the psychological factors that are most important in shaping people's fear of Covid-19. The researchers, led by Philip Millroth of Uppsala University in Sweden, found that people's general levels of risk tolerance and how we deal with uncertainty are more predictive of Covid-19 fear than other factors that one might expect to influence fear perceptions, such as age and health status.

I recently spoke with Dr. Millroth about this study. Here is a summary of our conversation.

What inspired you to investigate the topic of Covid-19 fear and what did you find?

I was intrigued by the notion that the decision science literature, with frameworks such as expected utility theory and prospect theory, so strongly emphasize the role of peoples' stable risk preferences in shaping what decisions people make, but that a lot of the studies backing up these claims (i) are conducted in laboratory behavioral experiments and (ii) seldom test alternative hypotheses to assert the impact of the role of risk attitudes — here we had a rare chance to study the concept of risk preferences in an ongoing real-life event to really test whether it is indeed a theoretical construct with strong potential to affect peoples' lives.

We found that peoples' risk preferences indeed were predictive of how strongly they feared different situations in connection with the pandemic: The more risk-averse people were, the more pandemic-related fear they experienced. Actually, risk preference was more predictive of fear levels than other factors that we beforehand knew would be important — such as age and depression levels.

Can you talk a little bit more about the constructs of general risk aversion and intolerance of uncertainty and how they connect with other psychological constructs?

One challenge when studying the topic of risk preferences is that the concept of risk can be conceptualized and measured in a variety of ways. Economists generally define risk in terms of outcome variance which provides a defined probability that something will happen, while clinical psychologists often use the term risk to imply a behavior with potentially harmful consequences. To complicate things, these two are in many real-life situations of course intertwined. Moreover, there is also the notion of uncertainty, which is complementary to the notion of risk: While risk refers to something that can, at least approximately be known (e.g., I run a risk of attracting COVID, with such and such probability), uncertainty concerns the unknown: sometimes we cannot imagine the possible future consequences of our behaviors, and even when we can we often have no idea how probable each of the consequences is of occurring.

The measurements we used to tap into all these different conceptualizations, and previous clinical research has indeed connected fear and anxiety levels with all of them, but more work is needed to assert more in detail how they complement each other. Moreover, we need to map to what extent the link between fear, risk, and uncertainty is moderated or mediated by related constructs such as impulsivity and sensation seeking.

You mention that general risk aversion and intolerance of uncertainty do a better job of predicting Covid-19 fear than demographic variables. Can you elaborate?

For a variety of factors, it is more likely that older people and people with lower socioeconomic status attract COVID and suffer more from attracting it — thus it is only sensible that they experience fear; fear is an adaptive response that has served the human race well in protecting us from danger. Risk aversion can have this adaptive protective function as well, and in novel situations such as the pandemic, it does indeed seem that it does indeed come into play more than objective factors that we as individuals and society can be aware of.

What are the clinical implications of your research?

Mental-health issues are on the rise since the pandemic started, for some individuals, these issues may be related to their risk preferences being either erroneously calibrated with facts or an ability to regulate their affective reactions initiated by the risk preference. Understanding the core mechanisms is going to be beneficial when providing clinical treatment.

What are some takeaways for everyday people looking for better ways to cope with the fear of the pandemic?

Most importantly, if you feel that the fear is becoming pathological — seek professional help from psychiatrists or clinical psychologists.

Would you say it is healthy to live with a certain degree of Coronavirus fear?

Absolutely — again, fear is an adaptive response that has evolved to protect us from harm. We should not treat fear in general — we should treat fear responses that have malfunctioned to the degree that they cause diagnosable mental-health issues.

Where would you like to see this research go next? Do you have any plans for follow-up studies?

We need to dig deeper into the causal mechanisms of how experiencing risk and uncertainty in different ways triggers fear and anxiety. Personally, I think we need to engage in more extensive theory integration; behavioral economists, cognitive psychologists, and clinical researchers in the 20th and 21st centuries have studied risk and uncertainty very much in parallel; it is time for increased connections across the fields.